Wave Of Coronavirus Disease 2019 Research Articles

Genomic epidemiology and evolutionary dynamics of the Omicron variant of SARS-CoV-2 during the fifth wave of COVID-19 in Pakistan

IntroductionThe coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has posed extraordinary challenges to global health systems and economies. The virus’s rapid evolution has resulted in several variants of concern (VOCs), including the highly transmissible Omicron variant, characterized by extensive mutations. In this study, we investigated the genetic diversity, population differentiation, and evolutionary dynamics of the Omicron VOC during the fifth wave of COVID-19 in Pakistan.MethodsA total of 954 Omicron genomes sequenced during the fifth wave of COVID-19 in Pakistan were analyzed. A Bayesian framework was employed for phylogenetic reconstructions, molecular dating, and population dynamics analysis.ResultsUsing a population genomics approach, we analyzed Pakistani Omicron samples, revealing low within-population genetic diversity and significant structural variation in the spike (S) protein. Phylogenetic analysis showed that the Omicron variant in Pakistan originated from two distinct lineages, BA.1 and BA.2, which were introduced from South Africa, Thailand, Spain, and Belgium. Omicron-specific mutations, including those in the receptor-binding domain, were identified. The estimated molecular evolutionary rate was 2.562E-3 mutations per site per year (95% HPD interval: 8.8067E-4 to 4.1462E-3). Bayesian skyline plot analysis indicated a significant population expansion at the end of 2021, coinciding with the global Omicron outbreak. Comparative analysis with other VOCs showed Omicron as a highly divergent, monophyletic group, suggesting a unique evolutionary pathway.ConclusionsThis study provides a comprehensive overview of Omicron’s genetic diversity, genomic epidemiology, and evolutionary dynamics in Pakistan, emphasizing the need for global collaboration in monitoring variants and enhancing pandemic preparedness.

Patient Characteristics and Clinical Outcomes During the 2020-2021 COVID-19 Wave: An Observational Study at a Tertiary Hospital in Saudi Arabia.

Background and objective The continued prevalence and threat of coronavirus disease 2019 (COVID-19) have been reported, and evidence suggests that several people still get infected with the virus. Gaining a thorough understanding of the patient demographic factors and laboratory findings could contributeto assessing the severity, mortality, and progression of COVID-19. In light of this, the current study aimed to evaluate the demographic characteristics, laboratory findings, and outcomes of confirmed COVID-19 patients at a tertiary hospital in the Kingdom of Saudi Arabia (KSA). Methodology We collected data spanning the period 2020-2021 from the electronic health records of Al-Noor Specialized Hospital, Maincluding demographics (age, gender, and nationality), severity (i.e., ICU admission), length of hospital stay, mortality, and laboratory parameters. Results We observed an overall mortality rate of10.2% (338 of 3,307 patients). The mortality rate was significantly higher in males (n=210; 62.1%) and patients aged more than 70 years (n=91; 26.9%). Patients with blood group O comprised 131 (29%) of the 338 non-survivors, followed by those with A (n=85; 25.1%) and Bgroups (n=79; 23.4%). The mortality rate among ICU patients was 63.3% (n=214). Furthermore, the following laboratory findings showed abnormal mean values in terms of severity and mortality in COVID-19 patients: hemoglobin (HB) concentration, white blood cell (WBC) count, lymphocyte count (LC), C-reactive protein (CRP), creatinine (CREA), and uric acid (UA) levels. Conclusions Old age, male gender, and certain laboratory findings have a critical role inthe severity and mortality risk in COVID-19 patients. There was no significant association between blood type and the severity and mortality of COVID-19. Continuous monitoring based on these findings may be essential to managing COVID-19 patients.

Strength of Association between Coronavirus Disease 2019 and Neurological Disorders in Children: A Case-Control Study

Introduction: Evidence suggests potential neurological complications of coronavirus disease 2019 (COVID-19), particularly in adults. While case series have hinted at associations between COVID-19 and neurological disorders (NDs) in children, the extent of this link remains unclear. This study investigates temporal trends in NDs during the pandemic and assesses their potential association with COVID-19 infection in children. Methods: We analyzed national Thai hospitalization data (2017–2022) for children under 18 with specific NDs (acute transverse myelitis, central nervous system demyelination, neuromyelitis optica, optic neuritis, polyneuropathy, stroke). An interrupted time series analysis was employed to identify changes in the incidence trends of NDs following the declaration of the COVID-19 pandemic. A matched case-control analysis was conducted using data specific to the Thai COVID-19 outbreak period. This analysis aimed to estimate the association between recent/concurrent COVID-19 infection and NDs in children. A propensity score matching on age group, sex, and month of admission was performed before conducting logistic regression. Results: From 2017–2022, 1,721 children were admitted with NDs (2,474 admissions), with a male predominance (55%) and average age of 10.6 years. Significant slope change was observed in optical neuritis trends coinciding with the third COVID-19 wave. The case-control analysis included 468 cases and 2,340 controls. Children with NDs had a significantly higher prevalence of recent/concurrent COVID-19 (matched odds ratio: 1.95, 95% confidence interval: 1.21–3.16). Subgroup analysis revealed an association between stroke and recent/concurrent COVID-19 (matched odds ratio: 3.05, 95% confidence interval: 1.3–7.16). Thus, this study suggests an association between recent/concurrent COVID-19 and NDs, especially pediatric stroke.

Factors Associated With the Suspension of Domiciliary Dental Care for Older Adults During the First Wave of the Coronavirus Disease 2019 (COVID-19) Pandemic: A Comparative Study in the Japanese Local Government.

Objective The novel coronavirus has reduced the availability of dental services, including domiciliary dental care. The suspension of dental treatment worsens the dental condition. However, the impact on domiciliary dental care during the coronavirus disease 2019 (COVID-19) pandemic remains unclear. Therefore, the aim of this study is to determine the impacts of the COVID-19 pandemic on domiciliary dental care and associated factors. Materials and methods This comparative study used Japanese prefectural claims data, including data from older adults who utilized domiciliary dental care. We compared the suspension of dental treatment during the firstwave of the COVID-19 pandemic with that before the COVID-19 pandemic. The outcome was the completion of four consecutive months of treatment. The chi-squared test, t-test, and logistic regression were applied. Result Approximately 23.4% of participants suspended home dental services during the first wave of the COVID-19 pandemic, whereas 11.7% suspended these services before COVID-19. Logistic regression clarified the effect of the following variables (during the first wave of COVID-19 vs. before COVID-19): care need level of long-term care was 1-5 (=severe) (odds ratio (OR): 0.92 vs. no significance (NS)), visit by hospital dentists (OR: 1.83 vs. NS), volume of patients in the visited place (2-9 people, OR: NS vs. 0.72; over 10 people, OR: 0.58 vs. 0.32), planned physicians' visit (OR: 0.71 vs. 0.77), and taxed income per population (OR: NS vs. 1.00). Discussion Domiciliary dental care, especially those in care facilities, were a vulnerable population during the pandemic. This may contribute to the delivery of domiciliary dental care during any future pandemics.

Surviving the storm: Wave-wise comparison of the pandemic's impact on mental health dynamics, sleep patterns, and preventive behaviors among coronavirus patients in Northern India.

Different clinical manifestations were revealed by the distinct waves of the coronavirus. The pandemic had a multifaceted impact on mental health, sleep patterns, and associated fear. It was an observational online survey using by using Google Forms in the city of Chandigarh between April 2020 and April 2021 across three waves of the coronavirus outbreak (first wave from March 2020 to May 2020, second wave from June 2020 to January 2021, and third wave from February 2021 to April 2021). Fear of coronavirus disease (COVID), preventive behaviors, insomnia-related problems, and impact of the event were assessed by using standardized scales. The participants who were infected during the first phase exhibited significantly higher levels of distress, loss of control over their reactions, increased fear of coronavirus and sleep problems, and also greater adherence to preventive behaviors compared to those who were infected during the second and third waves. A tendency to emerge post-traumatic stress disorder (PTSD) was seen in 68 (58.1%) of the participants (Peritraumatic Distress Inventory (PDI) score >14) and 34 (29.1%) of all the participants (PDI score >23). Overall, 66 (56.4%) participants reported having insomnia. About 24 people (20.5%) had clinical concerns about PTSD, 20 people (17.1%) had probable PTSD diagnoses, and 16 people (13.7%) experienced a severe coronavirus disease 2019 (COVID-19) pandemic impact on their lives. The first wave of COVID-19 had a greater psychological impact than subsequent waves. Further research must fill important gaps in our knowledge of the clinical range and long-term effects.

Determinants of persistence and recovery of chronic coronavirus disease 2019 chemosensory dysfunction

In 2% to 4% of patients, coronavirus disease 2019 (COVID-19) chemosensory dysfunction (CSD) persists beyond 6 months, accounting for up to 4 million people in the United States. The predictors of persistence and recovery require further exploration. We sought to define the predictors of recovery and assess the quality of CSD in registry subjects with self-reported persistent smell and taste dysfunction after COVID-19. COVID-19 CSD participants (n= 408) from the 4 major waves of the pandemic completed questionnaires at 4 time points between 2021 and 2023, assessing demographics, sinonasal symptoms, and self-assessed recovery. Objective measurements of smell (UPSIT) and taste (BWETT) were performed on a subcohort (n= 108). In this chronic CSD cohort, the average symptom duration was 24± 5 months, with 70% of those who contracted COVID-19 in 2020 report ongoing dysfunction. Phantosmia and dysgeusia were most prevalent in the early waves of COVID-19, while most participants reported disrupted ability to distinguish scents and flavors as well as undulating chemosensory function. Subjects reported low incidence of subjective sinonasal symptoms but high prevalence of sleep and mood disturbance. Cigarette smoke phantosmia was predictive of persistence of CSD. Conversely, self-reported environmental allergies and hypertension were predictive of recovery, and dust mite allergies specifically were negative predictors of cigarette smoke phantosmia. Finally, no treatment resolved CSD, but nasal steroids were reported to be effective by recovered CSD subjects. Objective measures of both smell and taste were significantly reduced in patients with chronic CSD compared to controls. Chronic COVID-19 CSD is a syndrome resistant to standard anti-inflammatory therapy. Preexisting environmental allergies and hypertension predict recovery, while cigarette smoke phantosmia predicts persistence.

Risk factors for severe outcomes of coronavirus disease 2019 through the waves of the pandemic: Comparing patients with and without solid organ transplantation.

While coronavirus disease 2019 (COVID-19) is no longer a public health emergency, certain patients remain at risk of severe outcomes. To better understand changing risk profiles, we studied the risk factors for patients with and without solid organ transplantation (SOT) through the various waves of the pandemic. Using the National COVID Cohort Collaborative we studied a cohort of adult patients testing positive for COVID-19 between January 1, 2020, and May 2, 2022. We separated the data into waves of COVID-19 as defined by the Centers for Disease Control. In our primary outcome, we used multivariable survival analysis to look at various risk factors for hospitalization in those with and without SOT. A total of 3,570,032 patients were captured. We found an overall risk attenuation of adverse COVID-19-associated outcomes over time. In both non-SOT and SOT populations, diabetes, chronic kidney disease, and congestive heart failure were risk factors for hospitalization. For SOT specifically, longer time periods between transplant and COVID-19 were protective and age was a risk factor. Notably, asthma was not a risk factor for major adverse renal cardiovascular events, hospitalization, or mortality in either group. Our study provides a longitudinal view of the risks associated with adverse COVID-related outcomes amongst SOT and non-SOT patients, and how these risk factors evolved over time. Our work will help inform providers and policymakers to better target high-risk patients.

Evaluation of Burnout among Medical Officers and Dental Surgeons in State Health Services using Maslach's Burnout Inventory during COVID-19: A Cross Sectional Study.

The Coronavirus disease 2019 (COVID-19) pandemic became a worldwide public health crisis. It leads to raised levels of burnout and anxiety among the people of the medical and dental fraternity, especially those involved in various duties related to COVID-19. The present research focused on evaluating the prevalence and predictors of burnout among medical officers and dental surgeons in Haryana's state dental health services. A cross-sectional study was conducted to assess burnout among medical officers and dental surgeons involved in COVID-19-related duties in state health services. Maslach's burnout scale was used to evaluate burnout. It is a prevalidated and self-administered questionnaire with three domains, that is, emotional exhaustion (EE), personal accomplishment (PA) assessment, and depersonalization (DP). The Chi square test, Student's t test (unpaired), and analysis of variance (ANOVA) with post hoc analysis were done wherever applicable. Pearson's correlation analysis was used to check the relationship among EE, DP, and PA. A total of 200 study participants responded to the online survey. Nearly half of them (51%) were aged 25-34 years. The majority had service experience of up to 20 years (90%). Almost three-fourths (72%) of study participants performed duties for >8 h a day. Up to 86% reported that the second wave of COVID-19 caused increased burnout. Moderate-to-high degrees of occupational exhaustion (OE) and DP were reported among approximately 42% of study participants. Medical officers were reported to have statistically significantly higher levels of burnout compared to dental surgeons (P < 0.05). Moderate levels of burnout were reported among half of the study participants, suggestive of the need to address the issues related to mental health of healthcare providers.

Bayesian probability revision and infection prevention behavior in Japan: A quantitative analysis of the first wave of COVID-19

The relationship between cognitive biases and infection prevention behavior remains unexplored in the existing literature. This study uses data from a questionnaire survey conducted in Japan on the first wave of Coronavirus Disease 2019 (COVID-19) from February to May 2020 to empirically investigate the impact of Bayesian probability inference, the influence of cognitive biases of PCR test results on infection prevention behavior, and the discrepancy between infection prevention intentions and behaviors. We used a bivariate ordinal probit model when considering the correlation between behaviors. The results showed that the higher probability responses, implying pessimistic biases, were more likely to indicate that declaring a state of emergency was necessary and effective, and were more health-oriented in ensuring infection prevention behavior even at the expense of the economy. However, the study found that although they wanted to reduce the frequency of their outings and the number of people they met, they did not reduce them in terms of actual behavior change. It also found that those with pessimistic biases had a higher WTP for the vaccine.

Comparison of T cell maturation profiles in the 1st and 5th wave of COVID-19 in the Polish population.

The coronavirus pandemic has become the most critical global health threat of this century and the greatest challenge to the human population. The search for simple and quick diagnostic methods enabling the identification of patients infected with the SARS-CoV-2 virus may be a valuable method to track infection. The aim of the study was the clinical and immunological characterization of patients by assessing the degrees of maturity of T lymphocytes from the 1st and 5th waves of coronavirus disease 2019 (COVID-19) in comparison to a healthy control group (HC). We determined leukocyte and T lymphocyte subpopulations (recent thymic emigrant (RTE), naïve, effector, central memory and effector memory) in patients from the 1st COVID-19 wave (n = 23), the 5th COVID-19 wave (n = 38) and HC (n=20) using a panel of monoclonal antibodies using multiparameter flow cytometry. We observed a lower median proportion of lymphocytes and NK cells, and elevated percentage and number of neutrophils in patients from the 5th wave compared to the 1st. We found a reduced percentage of CD4+ effector memory cells in the 1st wave group compared to the 5th wave (14.1 vs 23.2, p < 0.05), and a higher percentage of RTE and naïve CD8+ cells in the 1st wave compared to the 5th wave (p < 0.05). The effector memory CD8+ cells were highest in the 5th wave compared to both 1st wave and HC patients (respectively, 35.1 vs 18.1 vs 19.3%, p < 0.05). The 5th wave group showed significantly more differences compared to HC. Our results showed a clear increase of effector cells with a simultaneous decrease in virgin T cells in the 5th COVID-19 infection. Monitoring lymphocyte subsets during infection allows assessment of the patient's immune status and of readiness of lymphocytes to respond to the immune response, and may be necessary to improve clinical outcomes.

Mental Health of Teachers during the First Wave of COVID-19 in Daegu, Korea: Challenges in Reopening Schools

This study conducted an in-depth analysis of the psychological states of teachers during the first outbreak of coronavirus disease 2019 (COVID-19) using data on school mental health projects related to COVID-19 in Daegu from May to June 2020. The participants comprised 811 (34.9%) male and 1,511 (65.1%) female teachers in 1,041 (44.8%) middle and 1,281 (55.2%) high schools. After schools reopened, the most common causes of unbearable stress were unusual experiences, fear of infection, and negative emotions. Moreover, 41.5%/40.4% reported experiencing anxiety/depression, out of which 25.1%/23.6%, 10.0%/14.0%, and 6.4%/2.8% exhibited mild, moderate, and severe levels, respectively. The study identified the following influencing factors of anxiety: being female (OR: 1.52), years of employment (≤5 and &lt;15; OR: 1.36; reference: &lt;5), average monthly household income (≤3,000,000 and &lt;5,000,000 [OR: 0.69], 5,000,000 ≤ [OR: 0.67]; reference ≤1,000,000 and &lt;3,000,000 won), depression (OR: 19.14), posttraumatic stress symptoms (OR: 11.65), job stress (OR: 9.13), resilience (OR: 0.37), and subjective well-being (OR: 0.45). We identified the following factors for depression: being female (OR: 1.51), aged 40s (OR: 1.70; reference: 20s), average monthly household income (≤3,000,000 and &lt;5,000,000 [OR: 0.75], ≤5,000,000 [OR: 0.66]; reference: ≤1,000,000 and &lt;3,000,000 won), anxiety (OR: 19.14), posttraumatic stress symptoms (OR: 4.03), job stress (OR: 14.04), resilience (OR: 0.29), and subjective well-being (OR: 0.33). The findings suggest a necessity for specific, systematic measures and psychological support to teachers vulnerable to the impact of disasters, such as the COVID-19 pandemic, to cope with disasters and improve school adaptation.

Impact of the 2nd, 3rd and 4th waves of the COVID-19 pandemic on wait times in head and neck cancer: A retrospective study in a French expert center

BackgroundTreatment delay in head and neck cancer is a major problem, with impact on survival. The COVID-19 (coronavirus disease 2019) pandemic, evolving in waves around the world, caused diagnostic and therapeutic delays in certain cancers. The main objective of the present study was to analyze whether there was a change in wait times during three successive waves in our center. MethodThis was a single-center retrospective study of patients with a first diagnosis of head and neck cancer. Three groups, corresponding to waves 2, 3 and 4, were compared to a control group corresponding to a pre-pandemic period. Study data comprised median times between first consultation and tumor board meeting (C1-TB) and between tumor board meeting and treatment (TB-T). The significance threshold was set at P<0.005. ResultsNinety-six patients were included in the control group, and 154 in the “waves 2-3-4” group. There was no increase in C1-TB interval (respectively 35 and 26days, P=0.046) or TB-T interval (respectively 27 and 28days, P=0.723). ConclusionIntervals between first consultation and tumor board meeting and between tumor board meeting and treatment did not increase during the 2nd, 3rd and 4th waves of COVID-19 in our center.

Risk Factors for COVID-19 Cluster Infection in Hospitalized Patients.

Introduction In Japan, in the seventh wave of coronavirus disease 2019 (COVID-19) from July 2022 to September 2022, followed by the eighth wave of COVID-19 from November 2022 to January 2023, nosocomial clusters became more frequent in many healthcare facilities. If a cluster occurs in a hospital, the restrictions on general healthcare and the impact on hospital management, as well as the impact on community healthcare, are enormous. We analyzed the risk factors for COVID-19 cluster infection in hospitalized patients. Methods We retrospectively collected cases of COVID-19 infection among hospitalized patients in the seventh and eighth waves. The occurrence of a COVID-19 patient in a hospitalized patient was defined as one event. Results A total of 40 events were observed in the seventh and eighth waves. There were 17 events that developed into clusters. The following factors showed a significant association with cluster infection in a univariate analysis: "seventh wave," "originated from healthcare worker," and "initial examination according to contact list." The multivariate analysis revealed that "originated from healthcare worker" was independently associated with cluster infection. Conclusion Preventing the development of COVID-19 clusters is very important for nosocomial infection control. Our study suggests that COVID-19 infection in a healthcare worker is a risk factor for the development of a cluster. When healthcare workers are infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is often due to household transmission. Measures against household transmissions are important to prevent infection among healthcare workers.

The impact and management of internet-based public opinion dissemination during emergencies: A case study of Baidu News during the first wave of coronavirus disease 2019 (COVID-19).

The coronavirus disease 2019 (COVID-19) public health emergency has had a huge impact worldwide. We analyzed news headlines and keywords from the initial period of COVID-19, and explored the dissemination timeline of news related to the epidemic, and the impact of Internet-based media on the public using lifecycle theory and agenda-setting theory. We aimed to explore the impact of Baidu news headlines on public attention during the first wave of COVID-19, as well as the management mechanism of regulatory departments for social public opinion. We searched Baidu News using the keywords "Novel Coronavirus" and "COVID-19" from 8 January to 21 February 2020, a total of 45 days, and used Python V3.6 to extract news samples during the first wave of the epidemic. We used text analysis software to structurally process captured news topics and content summaries, applied VOSviewer V6.19 and Ucinet V6.0 to examine key aspects of the data. We analyzed the impact of Baidu News headlines on social opinion during the first wave of COVID-19 in the budding, spread, and outbreak stage of the information lifecycle. From clustering visualization and social network analysis perspectives, we explored the characteristics of Baidu News during the initial stage of the COVID-19. The results indicated that agenda-setting coverage through online media helped to mitigate the negative impact of COVID-19. The findings revealed that news reporting generated a high level of public attention toward a specific emergency event. The public requires accurate and objective information on the progress of COVID-19 through Baidu News headlines to inform their planning for the epidemic. Meanwhile, government can enhance the management mechanism of news dissemination, correct false and inaccurate news, and guide public opinion in a positive direction. In addition, timely official announcements on the progress of the COVID-19 outbreak and responses to matters of public concern can help calm tensions and maintain social stability.

Metagenomic insights into fungal community composition of the nasopharyngeal region of COVID-19 associated mucormycosis patients from India.

Coronavirus disease 2019 (COVID-19) associated mucormycosis (CAM) was reported predominantly from India during the second wave of COVID-19 and has a high mortality rate. The present study aims to understand the fungal community composition of the nasopharyngeal region of CAM-infected individuals and compare it with severe COVID-19 patients and healthy controls. The fungal community composition was decoded by analyzing the sequence homology of theinternal transcribed spacer-2-(ITS-2)region of metagenomic DNA extracted from the upper respiratory samples. The alpha-diversity indices were found to be significantly altered in CAM patients (p < 0.05). Interestingly, a higher abundance of Candida africana, Candida haemuloni, Starmerella floris, and Starmerella lactiscondensi was observed exclusively in CAM patients. The interindividual changes in mycobiome composition were well supported by beta-diversity analysis (p < 0.05). The current study provides insights into the dysbiosis of the nasal mycobiome during CAM infection. In conclusion, our study shows that severe COVID-19 and CAM are associated with alteration in mycobiomeas compared to healthy controls. However, the sequential alteration in the fungal flora which ultimately leads to the development of CAM needs to be addressed by future studies.

Mask-Wearing Behavior Among Individuals Newly Diagnosed With Type 2 Diabetes: Insights From Community Health Screenings During the COVID-19 Pandemic in Indonesia

The coronavirus disease 2019 (COVID-19) pandemic has had a severe impact on people with type 2 diabete (T2D) and their health behaviors. This study investigated the associations between T2D status and mask-wearing behaviors in public settings during the first wave of COVID-19 among community residents in Yogyakarta, Indonesia. Outreach health checkups and self-report questionnaires were cross-sectionally conducted to measure for mask-wearing behavior, T2D status, and sociodemographic characteristics. Chi-square tests, bivariate, and multivariate logistic regression were performed for data analysis. Out of 254 total participants, nearly one forth (24%) of them were newly diagnosed with T2D, while 15% of them reported that they had ever been diagnosed as T2D before. There were no statistically significant associations between mask-wearing behavior and T2D status in bivariate and multivariate logistic regression models. However, Chi-square test results showed significant differences (P=0.02) in percentages of inconsistent mask-wearing behavior among those who were newly diagnosed as T2D (19.4%), those who had known as T2D (7.9%), and those who had no T2D (7.1%). This discrepancy in the results suggests the need for further investigations using larger sample size and more representative community samples to examine the associations between mask-wearing behaviors and T2D. Early diagnostic services and the awareness education for T2D is imperative to reduce the disease severity and mortality for future pandemic particularly among undiagnosed individuals who are unaware of their T2D status,

Host genetic variants associated with COVID-19 reconsidered in a Slovak cohort

We present the results of an association study involving hospitalized coronavirus disease 2019 (COVID-19) patients with a clinical background during the 3rd pandemic wave of COVID-19 in Slovakia. Seventeen single nucleotide variants (SNVs) in the eleven most relevant genes, according to the COVID-19 Host Genetics Initiative, were investigated. Our study confirms the validity of the influence of LZTFL1 and 2′-5′-oligoadenylate synthetase (OAS)1/OAS3 genetic variants on the severity of COVID-19. For two LZTFL1 SNVs in complete linkage disequilibrium, rs17713054 and rs73064425, the odds ratios of baseline allelic associations and logistic regressions (LR) adjusted for age and sex ranged in the four tested designs from 2.04 to 2.41 and from 2.05 to 3.98, respectively. The OAS1/OAS3 haplotype ‘gttg’ carrying a functional allele G of splice-acceptor variant rs10774671 manifested its protective function in the Delta pandemic wave. Significant baseline allelic associations of two DPP9 variants in all tested designs and two IFNAR2 variants in the Omicron pandemic wave were not confirmed by adjusted LR. Nevertheless, adjusted LR showed significant associations of NOTCH4 rs3131294 and TYK2 rs2304256 variants with severity of COVID-19. Hospitalized patients' reported comorbidities were not correlated with genetic variants, except for obesity, smoking (IFNAR2), and hypertension (NOTCH4). The results of our study suggest that host genetic variations have an impact on the severity and duration of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Considering the differences in allelic associations between pandemic waves, they support the hypothesis that every new SARS-CoV-2 variant may modify the host immune response by reconfiguring involved pathways.

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.

Trend of viral load during the first, second, and third wave of COVID-19 in the Indian Himalayan region: an observational study of the Uttarakhand state.

India had faced three waves throughout the Coronavirus disease 2019 (COVID-19) pandemic, which had already impacted economic lives and affected the healthcare setting and infrastructure. The widespread impacts have inspired researchers to look for clinical indicators of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection prognosis. Cyclic threshold values have been used to correlate the viral load in COVID-19 patients and for viral transmission. In light of this correlation, a retrospective study was conducted to assess the trend of viral load in clinical and demographic profiles across the three waves. Data of a total of 11,125 COVID-19-positive patients were obtained, which had a Ct value of <35. We stratified Ct values as follows: under 25 (high viral load), 25-30 (moderate viral load), and over 30 (low viral load). We found a significantly high proportion of patients with high viral load during the second wave. A significantly high viral load across the symptomatic and vaccinated populations was found in all three waves, whereas a significantly high viral load across age groups was found only in the first wave. With the widespread availability of real-time PCR and the limited use of genomic surveillance, the Ct value and viral load could be a suitable tool for population-level monitoring and forecasting.

Impact of Sedation Practices on Mortality in COVID-19-Associated Adult Respiratory Distress Syndrome Patients: A Multicenter Retrospective Descriptive Study.

Background: Reduction in sedation exposure is an important metric in intensive care unit (ICU) patients. However, challenges arose during the coronavirus disease-2019 (COVID-19) pandemic in adhering to this practice, driven by concerns on transmission and disease severity issues. Accordingly, diverse sedation approaches emerged, although the effect on mortality has not been studied thoroughly. Methods: Retrospective cohort study in the medical ICU of seven hospitals within a major Health System in Northeast Ohio. We included all adult patients admitted with COVID-19 requiring invasive mechanical ventilation (IMV) from March 2020 to December 2021. Results: Study included 2394 COVID-19 patients requiring IMV. Across waves, sample included 55-63% male subjects, with an average age of 61-68 years (P < 0.001), Acute Physiologic and Chronic Health Evaluation (APACHE)-III score 65.8-68.9 (P = 0.37), median IMV duration 8-10 days (P = 0.14), and median ICU duration 9.8-11.6 days (P = 0.084). Propofol remained the primary sedative (84-92%; P = 0.089). Ketamine use increased from the first (9.7%) to fourth (19%) wave (P = 0.002). Midazolam use decreased from the first (27.4%) to third (9.4%) wave (P = 0.001). Dexmedetomidine use declined from 35% to 27-28% (P = 0.002) after the first wave. A multivariable regression analysis indicated clinical variables explained 34% of the variation in hospital mortality (R2). Factors associated with higher mortality included age [aOR = 1.059 (95% CI 1.049-1.069); P < 0.001], COVID-19 wave, especially fourth wave [aOR = 2.147, (95% CI 1.370-3.365); P = 0.001], and higher number of vasopressors [aOR = 31.636, (95% CI 17.603-56.856); P < 0.001]. Addition of sedative medications to a second model led to an increase in the R2 by only 1.6% to 35.6% [aOR = 1 (95% CI 1-1); P > 0.05] for propofol, ketamine, and midazolam. Dexmedetomidine demonstrated a decrease in the odds of mortality [aOR = 0.96 (95% CI 0.94-0.97); P < 0.001]. Conclusion: Mortality in critical COVID-19 patients was mostly driven by illness severity, and the choice of sedation might have minimal impact when other factors are controlled.