Coronavirus Disease 2019 Status Research Articles

Changes in the ocular surface microbiome of patients with coronavirus disease 2019 (COVID-19)

PurposeTo elucidate the reasons behind the increased incidence of ocular disease in patients with coronavirus disease 2019 (COVID-19), this study delved deeper into the specific effects of COVID-19 on patients’ ocular surface microbiome (OSM) and investigated its relationship with the increased incidence of ocular disease.MethodsIn this study, conjunctival sac swabs were collected from 43 participants for 16S rRNA amplicon sequencing. The participants were categorized into three groups based on their COVID-19 status: the control group (C group) consisted of 15 participants who showed no evidence of COVID-19, the experimental group (E group) included 15 participants who tested positive for COVID-19, and the COVID-19 recovery period group (R group) comprised 13 participants.ResultsIn the comparison of alpha diversity, group E had a higher Shannon, Chao1 and Goods coverage index. When comparing beta diversity, groups E and R were more similar to each other. At the phylum level, although the OSM of the three groups was dominated by Proteobacteria, Actinobacteriota, Bacteroidota and Firmicutes, the compositional proportions were significantly different. At the genus level, the dominant species in the three OSM groups were significantly different, with Pseudomonas becoming the dominant genus in groups E and R compared to group C, and the abundance of Ralstonia decreasing significantly.ConclusionThis study provides additional evidence supporting the association between the OSM and COVID-19, which contributes to our understanding of the potential mechanisms underlying ocular symptoms and complications associated with COVID-19 in the future.

Changes in the ocular surface microbiome of patients with coronavirus disease 2019 (COVID-19)

PurposeTo elucidate the reasons behind the increased incidence of ocular disease in patients with coronavirus disease 2019 (COVID-19), this study delved deeper into the specific effects of COVID-19 on patients’ ocular surface microbiome (OSM) and investigated its relationship with the increased incidence of ocular disease.MethodsIn this study, conjunctival sac swabs were collected from 43 participants for 16S rRNA amplicon sequencing. The participants were categorized into three groups based on their COVID-19 status: the control group (C group) consisted of 15 participants who showed no evidence of COVID-19, the experimental group (E group) included 15 participants who tested positive for COVID-19, and the COVID-19 recovery period group (R group) comprised 13 participants.ResultsIn the comparison of alpha diversity, group E had a higher Shannon, Chao1 and Goods coverage index. When comparing beta diversity, groups E and R were more similar to each other. At the phylum level, although the OSM of the three groups was dominated by Proteobacteria, Actinobacteriota, Bacteroidota and Firmicutes, the compositional proportions were significantly different. At the genus level, the dominant species in the three OSM groups were significantly different, with Pseudomonas becoming the dominant genus in groups E and R compared to group C, and the abundance of Ralstonia decreasing significantly.ConclusionThis study provides additional evidence supporting the association between the OSM and COVID-19, which contributes to our understanding of the potential mechanisms underlying ocular symptoms and complications associated with COVID-19 in the future.

Association between D-Dimer and the Severity of COVID-19

Abstract Background Coronavirus disease-2019 (COVID-19) is a global health crisis. The clinical characteristics, disease progression and outcome in children appear significantly milder compared to older individuals. Symptoms, although variable, depend on the stage of the disease, the prior health status, and the presence of comorbidities and other individual features. The risk factors for morbidity and mortality include comorbidities such as diabetes, chronic pulmonary disease, and cardiac pathology. Thus, prompt diagnosis is vital, given the evolution of the disease, with ARDS potentially occurring at 1 week after symptom onset. Objective To investigate the prognostic value of D-dimer levels measured on admission in COVID-19 patients. Patients and Methods We performed a retrospective observational study to investigate the prognostic value of D-dimer levels measured on admission in patients infected with novel Coronavirus Disease 2019 (COVID-19). The study enrolled 80 consecutive critically ill patients with test confirmed COVID-19 status attending Ain Shams University Hospital, intensive care units (Dimerdash Hospital). We retrospectively collected demographic, clinical data, laboratory parameters and prognosis. Results The best cutoff of D dimer in prediction of severe disease is ≥ 308 with area under curve of 0.897, sensitivity of 87%, specificity of 80.7%, positive predictive value (PPV) of 64.5%, negative predictive value of 93.9% and overall accuracy of 82.5% (p < 0.001). Statistically, there is statistically significant association between D dimer (≥308) and disease severity where D dimer significantly increased risk of having severe disease by 27.9 folds. The best cutoff of D dimer in prediction of mortality is ≥ 376 with area under curve of 0.839, sensitivity of 82.6%, specificity of 82.5%, positive predictive value (PPV) of 65.5%, negative predictive value of 92.2% and overall accuracy of 82.5% (p < 0.001). Statistically, there is significant association between D dimer (≥376) and mortality where D dimer significantly increased risk of mortality by 22.4 folds. In our study, there is statistically significant association between D dimer (≥376) and overall survival which was significantly higher in those with D dimer <376. Conclusion The prognosis of COVID-19 is poor in some group of patients. Unfortunately, an effective, globally accepted treatment algorithm for the treatment of COVID-19 has not yet been established. Additionally, the importance of anticoagulant therapy is increasing, as thrombotic events play a major role in mortality.

Effects of Preoperative COVID-19 Status on Emergent or Urgent Colectomy Outcomes.

Severe acute respiratory syndrome coronavirus 2 has been described as eliciting a powerful immune response. The association of coronavirus disease 2019 (COVID-19) infection with diseases requiring emergent or urgent colectomies may exacerbate the risk of surgical complications. We investigated the effect of preoperative COVID-19 infection on the clinical outcomes of patients who underwent a nonelective colectomy in 2021. We queried the American College of Surgeons National Surgical Quality Improvement Program Targeted Colectomy database for all of the patients who underwent a colectomy in 2021 and filtered for patients classified as "Urgent" or "Emergent." Two groups were created based on preoperative COVID-19 status: COVID+ (n = 242) and COVID- cohorts (n = 11,049). Several clinical variables were compared. Before filtering for urgent/emergent operations, a large percentage of COVID+ patients were found to have undergone an urgent or emergency colectomy (68.36% vs 25.05%). Preoperatively, these patients were more likely to be taking steroids (21.49% vs 12.41%) or have a bleeding issue requiring a transfusion (19.42% vs 11.00%). A larger percentage of infected patients returned to the operating room (14.05% vs 8.13%) and had a hospital stay >30 days (18.18% vs 5.35%). COVID-19 infection was associated with a higher rate of mortality (14.05% vs 8.08%) but did not independently predict it (odds ratio 1.25, P = 0.233), with all P ≤ 0.001. Urgent or emergent colectomy patients who were COVID-19+ preoperatively were more likely to present with comorbidities, which, along with the recent viral infection, contributed to markedly worse clinical outcomes, including an increased rate of mortality.

Host-microbiome associations in saliva predict COVID-19 severity.

Established evidence indicates that oral microbiota plays a crucial role in modulating host immune responses to viral infection. Following severe acute respiratory syndrome coronavirus 2, there are coordinated microbiome and inflammatory responses within the mucosal and systemic compartments that are unknown. The specific roles the oral microbiota and inflammatory cytokines play in the pathogenesis of coronavirus disease 2019 (COVID-19) are yet to be explored. Here, we evaluated the relationships between the salivary microbiome and host parameters in different groups of COVID-19 severity based on their oxygen requirement. Saliva and blood samples (n = 80) were collected from COVID-19 and from noninfected individuals. We characterized the oral microbiomes using 16S ribosomal RNA gene sequencing and evaluated saliva and serum cytokines and chemokines using multiplex analysis. Alpha diversity of the salivary microbial community was negatively associated with COVID-19 severity, while diversity increased with health. Integrated cytokine evaluations of saliva and serum showed that the oral host response was distinct from the systemic response. The hierarchical classification of COVID-19 status and respiratory severity using multiple modalities separately (i.e. microbiome, salivary cytokines, and systemic cytokines) and simultaneously (i.e. multimodal perturbation analyses) revealed that the microbiome perturbation analysis was the most informative for predicting COVID-19 status and severity, followed by the multimodal. Our findings suggest that oral microbiome and salivary cytokines may be predictive of COVID-19 status and severity, whereas atypical local mucosal immune suppression and systemic hyperinflammation provide new cues to understand the pathogenesis in immunologically compromised populations.

The effect of mask usage of the health personnel on blood gas analysis and cognitive strengthening during COVID-19 pandemic.

To investigate the effect of lengthy mask use on blood gas values and cognitive functions. The cross-sectional study was conducted in February and March 2022 at Mersin City Training and Research Hospital, Mersin, Turkey, and comprised healthcare professionals of either gender aged 20-60 years working in the 3rd level intensive care unit. Each volunteer was subjected to venous blood gas analysis at the beginning and end of the 8-hour morning shift. Coronavirus disease-2019 status was noted, and further data related to cognitive functions was collected using a 7-item questionnaire. Data was analysed using SPSS 20. Of the 63 subjects, 43(68.3%) were women and 20(31.7%) were men. The overall mean age was 33.53±6.76 years. There were 42(66.7%) subjects using N95 mask; 27(64.3%) women and 15(35.7%) men with mean age 32.38±6.54 years. There were 21(33.3%) subjects wearing surgical masks; 16(76.2%) women and 5(23.8%) men with mean age 35.95±0.76 years. Intergroup comparisons were non-significant for all the markers (p>0.05). Within the N95 mask group, potential of hydrogen and lactate values were significantly different (p<0.05), while in the surgical mask group, potential of hydrogen and partial pressure of oxygen were significantly different (p<0.05). There were 28(66.7%) subjects in the N95 group who had been affected by coronavirus disease-2019 compared to 16(76.2%) in the surgical mask group (p>0.05). Subjects in the N95 mask group had significant impaired cognitive functions compared to the surgical mask group (p<0.05). Impairment in cognitive functions in intensive care unit workers using masks could be explained by the development of intermittent long-term moderate hypoxia.

Impact of COVID-19 on posttraumatic stress disorder in ICU survivors: a prospective observational comparative cohort study

BackgroundPosttraumatic stress disorder (PTSD) after a stay in the intensive care unit (ICU) can affect one in five ICU survivors. At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, admission to the ICU for COVID-19 was stressful due to the severity of this disease. This study assessed whether admission to the ICU for COVID-19 was associated with a higher prevalence of PTSD compared with other causes of ICU admission after adjustment for pre-ICU psychological factors.MethodsThis prospective observational comparative cohort study included 31 ICUs. Eligible patients were adult ICU survivors hospitalized during the first wave of COVID-19 pandemic in France, regardless of the reason for admission. The prevalence of presumptive diagnosis of PTSD at 6 months was assessed using the PTSD Checklist for DSM-5 (PCL-5). Sociodemographics, clinical data, history of childhood trauma (Childhood Trauma Questionnaire [CTQ]), and exposure to potentially traumatic events (Life Events Checklist for DSM-5 [LEC-5]) were assessed.ResultsOf the 778 ICU survivors included during the first wave of COVID-19 pandemic in France, 417 and 361 were assigned to the COVID-19 and non-COVID-19 cohorts, respectively. Fourteen (4.9%) and 11 (4.9%), respectively, presented with presumptive diagnosis of PTSD at 6 months (p = 0.976). After adjusting for age, sex, severity score at admission, use of invasive mechanical ventilation, ICU duration, CTQ and LEC-5, COVID-19 status was not associated with presumptive diagnosis of PTSD using the PCL-5. Only female sex was associated with presumptive diagnosis of PTSD. However, COVID-19 patients reported significantly more intrusion and avoidance symptoms than non-COVID patients (39% vs. 29%, p = 0.015 and 27% vs. 19%, p = 0.030), respectively. The median PCL-5 score was higher in the COVID-19 than non-COVID-19 cohort (9 [3, 20] vs. 4 [2, 16], p = 0.034).ConclusionAdmission to the ICU for COVID-19 was not associated with a higher prevalence of PTSD compared with admission for another cause during the first wave of the COVID-19 pandemic in France. However, intrusion and avoidance symptoms were more frequent in COVID-19 patients than in non-COVID-19 patients.Trial Registration: Clinicaltrials.gov Identifier NCT03991611, registered on June 19, 2019.

Maternal and neonatal outcomes during COVID-19 pandemic and pre-pandemic in an urban slum in North India - A community-based ambispective cohort study.

Coronavirus disease 2019 (COVID-19) has affected millions of people globally since its first case reported on December 2019 in Wuhan, China. The maternal and neonatal outcomes during COVID-19 pandemic were not much reported in low- and middle-income countries. Therefore, we aimed to assess the maternal and neonatal outcomes during COVID-19 and compared them with those of the pre-pandemic period (i.e., 2019). We obtained data from the cohort of pregnant women who delivered during COVID-19 pandemic and women who delivered in the pre-pandemic period. All registered antenatal mothers resident of the selected dispensary who delivered in health care facilities from January 2019 to June 2019 and from January 2021 to June 2021 were included in the study for assessing the socio-demographic, antenatal, natal, post-natal, and new-born characteristics. A semi-structed questionnaire was used for obtaining details regarding pregnancy and COVID-19 status. The neuro-development assessment of the newborn was done in the community using Trivandrum Developmental Screening Chart (TDSC). Chi-square test and Fischer exact test were used to draw association between the maternal and neonatal outcomes during COVID-19 pandemic and the pre-COVID-19 period. A P value of <0.05 was considered statistically significant. A total of 158 and 220 women delivered in pre-COVID and during COVID, respectively. Out of them, 83 mothers (47.4%) who delivered in 2019 (pre-COVID) and 158 mothers (76.4%) who delivered in 2021 (during pandemic) were contacted. The mean age was 25 ± 3.9 years. The prevalence of anemia was significantly higher during COVID pandemic. The proportion of Rh-negative mothers and other antenatal investigation reports was similar in both the groups. The proportion of high-risk pregnancy is high among mothers who delivered during COVID than the pre-COVID period. On applying multivariate analysis, developmental delay at 3 months was found to be significant among children who were born during pandemic. A simple tool was used for assessing development milestones, and we have found that newborns delivered during COVID-19 pandemic were reported to have inappropriate developmental milestone at 3 months post-delivery. However, further research needed to assess the neuro-developmental status and follow-up of children born during COVID-19 pandemic for comprehensive neuro-developmental assessment. It is important to identify children with developmental delays associated with the pandemic and provide them with support for learning, socialization, physical and mental health, and family support.

Impact of Coronavirus Disease 2019 on Unresectable Hepatocellular Carcinoma Treated with Atezolizumab/Bevacizumab.

(1) Background: The coronavirus disease 2019 (COVID-19) pandemic has proven challenging to the management of patients with cancer, particularly those receiving systemic therapy. This study aimed to evaluate the impact of COVID-19 on patients with unresectable hepatocellular carcinoma (HCC) treated with atezolizumab/bevacizumab. (2) Methods: Patients with unresectable HCC who started atezolizumab/bevacizumab treatment between June 2020 and December 2021 at a tertiary cancer center in Korea were included (n = 241) and classified according to their COVID-19 status and severity. (3) Results: Thirty-five (14.5%) patients with unresectable HCC were diagnosed with COVID-19 during atezolizumab/bevacizumab treatment; 26 (74.2%) and nine (25.7%) in the low- and high-severity groups, respectively. The high-severity group showed higher neutrophil-to-lymphocyte ratios and lactate dehydrogenase levels. Liver and kidney injuries were observed in 31.4% and 17.1% of total patients, respectively. Liver injury was more prominent in patients with pre-existing liver dysfunction at baseline, who were more prevalent in the high-severity group. Atezolizumab/bevacizumab treatment was delayed by a median of 0 (range, 0-21) day in the low-severity group and 12 (range, 0-35) days in the high-severity group. The high-severity group showed worse post-infection progression-free survival (1.1 vs. 4.8 months, p = 0.017) and overall survival (2.2 months vs. not reached, p = 0.004). (4) Conclusions: Patients with impaired liver function at baseline are more susceptible to high-severity COVID-19, which affects atezolizumab/bevacizumab treatment outcomes.

P1222 Gut microbiome differences regarding lifestyle and the history of COVID-19 infection in ulcerative colitis patients

Abstract Background The microbiome contributes to the pathogenesis of ulcerative colitis (UC) but the contribution of different lifestyle and environmental factors to the compositional variability of the gut microbiota is unclear. Also, it is known that microbiota plays an important role in infectious diseases like coronavirus disease 2019 (COVID-19). Methods In 6-month time (June 2021 to December 2021) 49 UC outpatients from Riga East Clinical University Hospital were included in a Cross-sectional study. All patients were divided into groups according to COVID-19 status (COVID-19posvs COVID-19neg) within 6 months. The effect of the lifestyle (smoking cigarettes, alcohol intake, sports activities, and high psychological stress level) and COVID-19 to the gut microbiota in patients with UC was investigated. For taxonomical classifying of the gut microbiome metagenome data, MetaPhlAn v.2.6.0 tool was used. In further analysis gut microbiome (mostly bacteria phyla) and related data was analysed with SPSS 20.0. Results Out of 49 patients, 31(63%) were male and 18(37%) were female, the mean age was Md=38 [IQR:34-51]. Fourteen patients (28.6%) have been COVID-19 pos and 35(71.4%) COVID-19 neg. There were no statistically significant differences between COVID-19 pos and COVID-19 neg patients and their microbiota, nor between COVID-19 pos symptomatic 12(24.5%) and asymptomatic 37(75.5%) patients and their gut microbiome. Out of 49, 24(49%) were doing sports, of those 18(51.4%) were COVD-19neg vs. 6 (42.9%) COVID-19pos, p=0.82. Evaluating differences in the gut microbiome regarding physical activities there was no statistical significance. Of 49 patients, 30(61.2%) have smoked before, while 19(38.8%) haven’t smoked. Medium smoking time was 8 years Md=8 [IQR:4.50-20.0]. Analysing gut microbiome in smokers/non-smokers, and the length of smoking, there were found no statistically significant differences. Thirty-five (71.4%) were using alcohol, and 14(28.6%) were not. Those who were using alcohol had statistically significantly more Firmicutes in their gut microbiome Md= 64.8[IQR:53.7-70.4] than no users Md=48[IQR:37.5-66.3], p=0.041. Regarding high stress levels, those who had less stress 18(36.7%), had more Actinobacteria in their gut microbiome Md=11.7[IQR:6.92-14.8] vs stressful patients 31(63.3%) Md=6.03[IQR:2.23-13.8], p=0.03. Conclusion There were no changes in gut microbiome in COVID-19 positive and COVID-19 negative patients, nor in smokers and no smokers. Alcohol users had more bacteria Firmicutes in their gut microbiome. There were no differences in gut microbiome in UC patients doing or lacking sports. UC patients with less stress had more Actinobacteria in their gut microbiome.

Exploring the Impact of COVID-19 on Ulcerative Colitis Patients: A Lifestyle Perspective.

Background and Objectives: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 is the new coronavirus that caused the coronavirus disease 2019 (COVID-19) outbreak. Studies have increasingly reported the involvement of organs outside the respiratory system, including the gastrointestinal tract. Data on the association between COVID-19 and ulcerative colitis (UC) are lacking. Materials and Methods: In this one-centre cross-sectional study, 49 patients with UC from the Riga East Clinical University Hospital outpatient clinic were included from June 2021 to December 2021. The patients were divided into two groups according to their history of a confirmed positive or negative COVID-19 status. Data on their lifestyle, diet, and medications and the food supplements used by the patients were collected during interviews and analysed using the R 4.2.1 software. Results: Out of 49 patients, 33 (63.3%) were male and 13 (36.7%) were female, with a mean age of 32.33 ± 8.6 years. Fourteen patients (28.6%) had a confirmed COVID-19 infection in the last year. The most common COVID-19-related symptoms were a fever and rhinorrhoea. A third of patients followed the inflammatory bowel disease diet (16; 32.7%); out of these patients, 12 (34.3%) did not contract COVID-19 (OR: 0.78 (0.18; 2.98), p > 0.05). In the COVID-19-positive group, the majority of patients did not use vitamin D (11; 79% vs. 3; 21%, (OR: 0.38 (0.07; 1.51), p = 0.28) or probiotics (11; 78.6% vs. 3; 21.4%, OR: 1.33 (0.23; 6.28), p = 0.7). In the COVID-19-positive group, most patients did not smoke (12; 85.7% vs. 2; 14.3%, p = 0.475) and did not use alcohol (9; 64.3% vs. 5; 35.7%, OR: 0.63 (0.16; 2.57), p = 0.5). Most of the patients who participated in sports activities were COVID-negative (18; 51.4% vs. 6; 42.9%, p = 0.82). Conclusions: There were no statistically significant differences in the use of food supplements, probiotics, or vitamins; the lifestyle habits; or the COVID-19 status in patients with UC.

COVID-19 vaccination and transmission patterns among pregnant and postnatal women during the fifth wave of COVID-19 in a tertiary hospital in Hong Kong.

Vaccination is a key strategy to control the coronavirus disease 2019 (COVID-19) pandemic. Safety concerns strongly influence vaccine hesitancy. Disease transmission during pregnancy could exacerbate risks of preterm birth and perinatal mortality. This study examined patterns of vaccination and transmission among pregnant and postnatal women during the fifth wave of COVID-19 in Hong Kong. The Antenatal Record System and Clinical Management System of the Hospital Authority was used to retrieve information concerning the demographic characteristics, vaccination history, COVID-19 status, and obstetric outcomes of women who were booked for delivery at Queen Mary Hospital in Hong Kong and had attended the booking antenatal visit from 1 July 2021 to 30 June 2022. Among 2396 women in the cohort, 2006 (83.7%), 1843 (76.9%), and 831 (34.7%) had received the first, second, and third doses of COVID-19 vaccine, respectively. Among 1012 women who had received the second dose, 684 (67.6%) women were overdue for their third dose. There were 265 (11.1%) reported COVID-19 cases. Women aged 20 to 29 years had a low vaccination rate but the highest disease rate (19.1%). The disease rate was more than tenfold higher in women who had no (20.3%) or incomplete (18.8%) vaccination, compared with women who had complete vaccination (2.1%; P<0.001). Acceptance of COVID-19 vaccination was low in pregnant women. Urgent measures are needed to promote vaccination among pregnant women before the next wave of COVID-19.

Mental health, quality of life and self-management behaviours: online evaluation of inflammatory arthritis patients over 1 year of COVID-19 lockdowns

Abstract Objective Patients with inflammatory arthritis were especially vulnerable to the psychosocial and health impacts of coronavirus disease 2019 (COVID-19) and the lockdowns. This study investigated the impact of these changes on mental health, physical health and quality of life for inflammatory arthritis patients over 1 year following the initial lockdown in the UK. Methods Three hundred and thirty-eight participants with inflammatory arthritis completed an ambidirectional study consisting of online questionnaires at four time points for 1 year. The questionnaires assessed demographic information, inflammatory arthritis condition, mental health, physical symptoms, self-management behaviours, COVID-19 status and impacts. Means, linear regressions and structural equation modelling for mediations were conducted over 12 months. Results Physical health concerns peaked during June 2020, then declined, but did not return to baseline. Depression was associated with worse quality of life at baseline, as shown by the beta coefficient, (β= 0.94, P &amp;lt; 0.01), September (β = 0.92, P &amp;lt; 0.01), November (β= 0.77, P &amp;lt; 0.01) and 1 year (β = 0.77, P &amp;lt; 0.01). Likewise, anxiety was associated with worse quality of life at baseline (β = 1.92, P &amp;lt; 0.01), September (β = 2.06, P &amp;lt; 0.01), November (β = 1.66, P = 0.03) and 1 year (β = 1.51, P = 0.02). The association between depression and quality of life was mediated by physical activity (β= 0.13, P &amp;lt; 0.01) at baseline. The association between anxiety and quality of life was also mediated by physical activity (β = 0.25, P = 0.04) at baseline. Conclusion Physical health continued to be worse 1 year later compared with before the COVID-19 lockdowns in patients with inflammatory arthritis. Mental health showed long-term effects on quality of life, with an impact for ≥12 months. Lastly, physical activity mediated between mental health and quality of life in the short term.

Correlation of Diabetic Status and Coronavirus Disease 2019 (COVID-19) in Patients With Mucormycosis: A Retrospective Clinical Study.

Coronavirus disease 2019 (COVID-19) and its association with diabetes might lead to mucormycosis, and studies have reported an association between them. This study aims to find the correlation between COVID-19 and diabetic statusin patients with mucormycosis and its role in disease progression and prognosis. The objectives of the study are to analyze the clinical range of mucormycosis in those with diabetes and COVID-19 and to correlate the clinical and radiographic findings. A retrospective cohort analysis was carried out at Saveetha Dental College and Hospitals in Chennai (approval number: IHEC/SDC/OMED-2204/23/218). The data collection was done from the institution's electronic databasefrom April 2019 to April 2023 which included the patients' age and gender and COVID-19 and diabetic status and clinical and radiographic features of mucormycosis. From the data analyzed, 25 patients had a history of mucormycosis with diabetes and COVID-19 infections. The patients' average age was 47.76, out of which 22 were males and three were females. The chi-squared test showed no significant association between age (0.178), diabetes (0.465), and COVID-19 (0.583). Spearman's correlation was done showing an association between mucormycosis, diabetes, and COVID-19. Radiographically, 100% of the patients had involvement of the maxillary sinus, followed by the palate (32%), orbit (28%), nasal floor (24%), ethmoidal sinus (16%), sphenoidal sinus (12%), and frontal sinus (8%). The findings of this study point out the importance of considering the presence of systemic comorbidities like diabetes in COVID-19 patients. Early identification, surgical debridement, and antifungal medications are part of the treatment for increased survival.

CT and Angiographic Findings among COVID-19-Positive Patients Presenting with Stroke and Their Outcomes

Abstract Background The study aims to assess and compare the computed tomographic and angiographic findings and clinical outcomes among coronavirus disease 2019 (COVID-19)-positive and COVID-19-negative patients. Methods We conducted a retrospective study of all patients presenting with acute stroke to our facility between March 2020 and October 2021. Demographics, risk factors, COVID-19 status, National Institute of Health Stroke Scale (NIHSS), mode of treatment, length of hospital stay, imaging findings, and angiographic and clinical outcomes were extracted from electronic medical records. Descriptive statistics were used to summarize the data. Pregnant patients, those under the age of 18, and those found to have an alternative diagnosis were excluded. We identified 103 patients with acute stroke who underwent thrombolysis and/or mechanical thrombectomy, 16 of whom were found to be COVID-positive (study group), while 87 of them had negative status (control group). Results The mean age of both groups (COVID-19 positive and COVID-19 negative) was 56 years, and 85% were male. The most frequently involved vessel was the M1 segment of the middle cerebral artery (37% in COVID-19-positive patients vs. 41% in COVID-19-negative patients). Sixty-one patients underwent thrombectomy, and both groups had comparable successful recanalization. Patients with COVID-19 infection were more likely to have a more extended hospital stay and a higher average NIHSS score at discharge. Conclusion Our study shows that ischemic stroke in COVID-19 occurs in predominantly male patients, with the middle cerebral artery being the most frequently involved vascular territory. Furthermore, there is a longer hospital stay and worse morbidity regardless of the mode of treatment and imaging findings in COVID-19-positive patients.

A comparison of Delta and Omicron waves of COVID-19 pandemic: An observation from a tertiary care center from North India

Objectives: The impact of the Omicron variant (B.1.1.529) was very low as compared to the Delta variant (B.1.617.2) in North India. Very few studies are there highlighting the clinical parameters associated with disease outcomes among coronavirus disease-2019 (COVID-19) patients during the Delta and Omicron waves of the pandemic. This study was conducted to observe various clinical parameters associated with disease outcomes among COVID-19 patients during Delta and Omicron waves. Materials and Methods: This retrospective observational study was conducted during the Delta wave (March 2021 to June 2021) and Omicron wave (December 2021 to March 2022) on patients with positive reverse transcriptase–polymerase chain reaction (RT-PCR) admitted during the study period. The patient characteristics and outcome measures including demographic, baseline clinical, disease severity, intensive care unit admissions, and hospital mortality were recorded. Results: Out of total of 1731 patients who tested positive for severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) by RT-PCR, 16 patients were admitted during the omicron wave and 878 were admitted during the Delta wave. The majority of admitted patients during the Delta wave were in the age groups of 21–40 and 41–60 years, with significantly less number of admissions in the age group of &lt;20 years during the Omicron wave. The admissions were significantly lower during the Omicron wave (P &lt; 0.001). Patients without a previous history of COVID-19 and unvaccinated status were having significantly higher admissions (P &lt; 0.001). During Delta and Omicron waves 71.4% and 18.75% of the patients, respectively, were having no comorbidities. Conclusion: Hospital admissions were higher during the Delta wave in comparison to the Omicron wave. During the Delta wave, the degree of severity and number of deaths were also very high.

Comparison of The Nutritional Habits of Individuals With and Without a COVID-19 Diagnosis: An Online Cross-Sectional Study From Türkiye

Objective: Türkiye, which is located in the European Region of the World Health Organization (WHO) has been also affected by the Coronavirus Disease-2019 (COVID-19) pandemic. This study was conducted between January and April 2021, in which the number of daily COVID-19 cases increased from an average of 8,500 to 50,000. This cross-sectional online study aimed to compare the dietary habits of individuals with and without a COVID-19 diagnosis. &#x0D; Material and Method: The study included a total of 1,448 individuals aged 18-64 years. Study data were collected through the Google platform using a questionnaire that included sociodemographic characteristics, COVID-19 status, anthropometric measurements, physical activity status, and nutritional characteristics. &#x0D; Results: Those with COVID-19 had higher Body Mass Index (BMI) than those without COVID-19. The rates of those who had regular physical activity, considered nutrition important for protection from COVID-19, and ordered food online were lower among those participants with COVID-19 than those without COVID-19. The rates of those who lost appetite and weight, used nutritional supplements, increased their nutritional budget during the pandemic, and shopped for food from online marketplaces were higher too among those with COVID-19. Those with COVID-19 were found to consume red meat, fruit, and herbal tea more frequently and soft drinks less frequently than those without COVID-19. &#x0D; Conclusion: In line with these results, it may be considered that those with COVID-19 try to comply with healthy nutrition recommendations. Our results can be used to prepare appropriate nutritional guidelines for pandemic and quarantine periods.

Oral healthcare providers play a vital role in vaccination efforts: Patient perspectives.

Human papillomavirus (HPV) is associated with 70% of oropharyngeal squamous cell carcinomas. Coronavirus disease 2019 (COVID-19) is the infectious cause of a global pandemic that killed millions worldwide. Effective vaccinations exist against both diseases, but patient acceptance remains a challenge. The objective of this study was to assess patients' attitudes toward oral healthcare providers' (OHCPs) roles in HPV and COVID-19 vaccinations. A cross-sectional survey of young adult patients was distributed in Philadelphia, PA, between April and June 2021. The survey assessed knowledge and attitudes around OHCPs serving various roles in COVID-19 and HPV vaccination. Nearly 70% of 163 respondents would accept the recommendation for a COVID-19 vaccine from an OHCP, while 56% would for HPV. Those previously vaccinated against COVID-19 were more comfortable discussing COVID-19 vaccines (92%, p < .001) or HPV vaccines (76%, p < .001) with OHCPs compared to those who were unvaccinated against COVID-19. African American/Black patients were less comfortable discussing vaccines, irrespective of vaccination status. OHCP can play a vital role in increasing the overall COVID-19 and HPV vaccination status of the public, as demonstrated by the high acceptance of dental involvement in both vaccine campaigns. Racial disparity in vaccination attitude is a public health challenge that needs to be addressed.

Diminished Physical Activity in Older Hospitalised Patients with and without COVID-19.

Acute viral respiratory infections have proven to be a major health threat, even after the Corona Virus Disease 2019 (COVID-19) pandemic. We aimed to check whether the presence or absence of an acute respiratory infection such as COVID-19 can influence the physical activity of older hospitalised patients. We cross-sectionally studied patients aged ≥60 years, hospitalized during the pandemic in the non-COVID-19 and COVID-19 ward at the University Hospital, Kraków, Poland. Using activPAL3® technology, we assessed physical activity for 24 h upon admission and discharge. In addition, we applied the sarcopenia screening tool (SARC-F); measured the hand grip strength and calf circumference; and assessed the Modified Early Warning Score (MEWS), age-adjusted Charlson Index, SpO2%, and length of stay (LoS). Data were analysed using SAS 9.4. The mean (min, max) age of the 31 (58% women, eight with COVID-19) consecutive patients was 79.0 (62, 101, respectively) years. The daily time (activPAL3®, median [p5, p95], in hours) spent sitting or reclining was 23.7 [17.2, 24] upon admission and 23.5 [17.8, 24] at discharge. The time spent standing was 0.23 [0.0, 5.0] upon admission and 0.4 [0.0, 4.6] at discharge. The corresponding values for walking were 0.0 [0.0, 0.4] and 0.1 [0.0, 0.5]. SARC-F, admission hand grip strength, calf circumference, and LoS were correlated with physical activity upon admission and discharge (all p < 0.04). For every unit increase in SARC-F, there was a 0.07 h shorter walking time upon discharge. None of the above results differed between patients with and without COVID-19. The level of physical activity in older patients hospitalised during the pandemic was low, and was dependent on muscular function upon admission but not on COVID-19 status. This has ramifications for scenarios other than pandemic clinical scenarios.

Factors in Vaccine Refusal by Patients Applying for COVID-19 PCR Test.

This study was designed to determine the reasons for vaccine rejection in patients who applied for the coronavirus disease-2019 (COVID-19) polymerase chain reaction (PCR) test but did not receive the vaccine. The study was conducted prospectively in the emergency department of a tertiary hospital between 31.01.2022 and 31.05.2022. 1000 patients who applied for the COVID-19 PCR test and refused to be vaccinated were included. The COVID-19 status of the participants, reasons for their application, number of PCR tests, methods of obtaining information about the vaccine, and reasons for the rejection of the vaccine were questioned. 54.6% of the participants were male and 45.4% were female. 60.7% of the patients applied for testing due to symptoms, 25.4% due to contact with people with symptoms, and 23.9% due to travel. 43.3% of the cases had COVID-19 infection; 53.6% of them had tested an average of 2-5 times in the last year. Most of the information about the vaccine was taken from social media, television, medical publications, and people around, respectively. Of the participants, 62.0% believed that COVID-19 vaccines had side effects, 47.3% believed that it had no protection, and 30.9% believed that there was not enough study on the subject. As the age grew, the rate of learning information from social media increased. The most common reasons for COVID-19 vaccine rejection were vaccine side effects, doubtful vaccine protection, and concerns about the lack of sufficient studies on the vaccine. The higher the education level, the higher the vaccine rejection rate.