Coronavirus Disease Research Articles

Investigating the Relationship between COVID-19 In-hospital Death and Acute Kidney Injury

Introduction: Coronavirus Disease 2019 (COVID-19) can induce multiorgan failure, including acute kidney injury (AKI), which is associated with a poor prognosis. Some of these patients develop proteinuria, hematuria, and elevated serum creatinine, therefore some require hemodialysis. This study aimed to investigate the association between in-hospital death due to COVID-19 and the incidence of AKI. Methods: In a retrospective study, the available data of patients who died because of COVID-19 from April 1 to September 22, 2020 in a referral hospital was investigated using the case census method. Results: A total of 190 patients who died of COVID-19 were evaluated. Of these, 111 (58.42%) had AKI, with 108 (56.84%) being male. The mean age of the subjects was 66.16±15.43 years old. The mean time from hospital admission to death was about 9 days in all patients. Although not statistically significant, the findings showed that patients who developed AKI died sooner. The most frequent underlying diseases were hypertension [n= 101 (53.16%)] and diabetes [n= 44 (23.16%)]. Moreover, a higher proportion of subjects with AKI as compared to those without AKI were admitted to the intensive care unit (ICU), and had abnormal proteinuria profile (p-value=0.045 and 0.025, respectively). Conclusion: The incidence of AKI was 58.42% in patients who died from COVID-19 disease. Moreover, abnormal proteinuria and ICU admission were significantly higher in COVID-19 patients with AKI than in those without AKI.

Exploring the Molecular Mechanism of Niuxi-Mugua Formula in Treating Coronavirus Disease 2019 via Network Pharmacology, Computational Biology, and Surface Plasmon Resonance Verification.

In China, Niuxi-Mugua formula (NMF) has been widely used to prevent and treat coronavirus disease 2019 (COVID-19). However, the mechanism of NMF for treating COVID-19 is not yet fully understood. This study aimed to explore the potential mechanism of NMF for treating COVID- 19 by network pharmacology, computational biology, and surface plasmon resonance (SPR) verification. The NMF-compound-target network was constructed to screen the key compounds, and the Molecular Complex Detection (MCODE) tool was used to screen the preliminary key genes. The overlapped genes (OGEs) and the preliminary key genes were further analyzed by enrichment analysis. Then, the correlation analysis of immune signatures and the preliminary key genes was performed. Molecular docking and molecular dynamic (MD) simulation assays were applied to clarify the interactions between key compounds and key genes. Moreover, the SPR interaction experiment was used for further affinity kinetic verification. Lipid and atherosclerosis, TNF, IL-17, and NF-kappa B signaling pathways were the main pathways of NMF in the treatment of COVID-19. There was a positive correlation between almost the majority of immune signatures and all preliminary key genes. The key compounds and the key genes were screened out, and they were involved in the main pathways of NMF for treating COVID-19. Moreover, the binding affinities of most key compounds binding to key genes were good, and IL1B-Quercetin had the best binding stability. SPR analysis further demonstrated that IL1B-Quercetin showed good binding affinity. Our findings provided theoretical grounds for NMF in the treatment of COVID-19.

Associations between obesity and severity of coronavirus disease 2019 in Brazilian inpatients: A 2021 secondary data analysis.

In the backdrop of the global obesity pandemic, recognized as a notable risk factor for coronavirus disease 2019 (COVID-19) complications, the study aims to explore clinical and epidemiological attributes of hospitalized COVID-19 patients throughout 2021 in Brazil. Focused on four distinct age cohorts, the investigation scrutinizes parameters such as intensive care unit (ICU) admission frequency, invasive mechanical ventilation (IMV) usage, and in-hospital mortality among individuals with and without obesity. Using a comprehensive cross-sectional study methodology, encompassing adult COVID-19 cases, data sourced from the Influenza Epidemiological Surveillance Information System comprises 329 206 hospitalized patients. Of these individuals, 26.3% were affected by obesity. Analysis reveals elevated rates of ICU admissions, increased dependence on IMV, and heightened in-hospital mortality among the individuals with obesity across all age groups (p < .001). Logistic regression, adjusting for confounding variables, underscores a progressively rising odds ratio for mortality in younger age brackets: 1.2 (95%CI 1.1-1.3) for those under 50 years, 1.1 (95%CI 1.0-1.2) for the 50-59 age group, and 1.1 (95%CI 1.0-1.2) for the 60-69 age group. Conversely, no significant mortality difference is observed for patients over 70 years (OR: 0.972, 95%CI 0.9-1.1). In summary, hospitalized COVID-19 patients with obesity, particularly in younger age groups, exhibit elevated rates of ICU admission, IMV requirement, and in-hospital mortality compared with the control group. Notably, the 'obesity paradox' is not evident among hospitalized COVID-19 patients in 2021.

Discovery of a Potential Allosteric Site in the SARS-CoV-2 Spike Protein and Targeting Allosteric Inhibitor to Stabilize the RBD Down State using a Computational Approach.

The novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a worldwide public health crisis. At present, the development of effective drugs and/or related therapeutics is still the most urgent and important task for combating the virus. The viral entry and associated infectivity mainly rely on its envelope spike protein to recognize and bind to the host cell receptor angiotensin-converting enzyme 2 (ACE2) through a conformational switch of the spike receptor binding domain (RBD) from inactive to active state. Thus, it is of great significance to design an allosteric inhibitor targeting spike to lock it in the inactive and ACE2-inaccessible state. This study aims to discover the potential broad-spectrum allosteric inhibitors capable of binding and stabilizing the diverse spike variants, including the wild type, Delta, and Omicron, in the inactive RBD down state. In this work, we first detected a potential allosteric pocket within the SARS-CoV-2 spike protein. Then, we performed large-scale structure-based virtual screening by targeting the putative allosteric pocket to identify allosteric inhibitors that could stabilize the spike inactive state. Molecular dynamics simulations were further carried out to evaluate the effects of compound binding on the stability of spike RBD. Finally, we identified three potential allosteric inhibitors, CPD3, CPD5, and CPD6, against diverse SARS-CoV-2 variants, including Wild-type, Delta, and Omicron variants. Our simulation results showed that the three compounds could stably bind the predicted allosteric site and effectively stabilize the spike in the inactive state. The three compounds provide novel chemical structures for rational drug design targeting spike protein, which is expected to greatly assist in the development of new drugs against SARS-CoV-2.

Diphyllin elicits a doubled-pronged attack on the entry of SARS-CoV-2 by inhibiting cathepsin L and furin

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the coronavirus disease 2019 (COVID-19) pandemic, posing serious threats to global health. Effective broad-spectrum antiviral drugs for the treatment of COVID-19 are not sufficiently available. In the present study, we investigated the antiviral activity of the natural lignan diphyllin (PubChem CID 100492) against different SARS-CoV-2 variants and explored the underlying molecular mechanisms. We found that diphyllin dose-dependently inhibits the SARS-CoV-2 spike (S)-mediated entry into different types of cells. The potent inhibition was evident against spike proteins derived from the original SARS-CoV-2 and from variants of concern such as Alpha, Beta, Delta or Omicron. Accordingly, diphyllin also significantly inhibited the in vitro infection of a clinical SARS-CoV-2 virus isolate. Mechanistically, diphyllin simultaneously inhibited the endosomal entry of SARS-CoV-2 by neutralizing the endosomal acidification and reducing the activity of the cysteine protease cathepsin L (CTSL) as well as S-meditated cell surface entry by impairing furin activity. Collectively, our findings establish diphyllin as novel inhibitor of CTSL and furin proteases, resulting in a double-pronged attack on SARS-CoV-2 entry along endosomal as well as cell surface routes. Therefore, diphyllin has the potential to be advanced as an inhibitor of SARS-CoV-2 entry.

A retrospective analysis on the effectiveness of cytokine hemadsorption in patients with severe coronavirus disease 2019

Background: An increase in systemic inflammation due to hyperimmune activation leads to severe coronavirus disease 2019 (COVID-19) disease, acute respiratory distress syndrome, multiple organ failure, and ultimately death. Extracorporeal blood purification using hemadsorption to reduce excessive inflammatory cytokine was suggested as an effective treatment for patients with severe COVID-19. We investigated the effectiveness of intermittent cytokine hemadsorption with a HA330 cartridge in patients with severe COVID-19. Methods: We gathered data from severe COVID-19 patients who underwent hemadsorption using Jafron® (HA330) between October and December 2021. We assessed pre- and post-hemadsorption inflammatory cytokine levels, treatment complications, and mortality. Statistical significance was set at P &lt; 0.05. Results: Of the total 40 patients, 13 (32.5%) were males with a mean age of 63.6 years. In patients who survived (n = 23), a 2-fold decrease in interleukin-6 (IL-6, P = 0.0433), a 3-fold decrease in procalcitonin (P = 0.0163), a 2.5-fold decrease in C-reactive protein (CRP, P = 0.0080), a 2.5-fold increase in D-dimer (P = 0.0337), and a 1.3-fold increase in white blood cell (WBC) (P = 0.0102) were observed before and after cytokine hemadsorption. In patients who died (n = 17), a 2-fold increase in WBC (P = 0.0022) was observed with no significant changes in other parameters. Except for a few cases of platelet transfusion, catheter occlusion, hypotension, and hematoma, no other complications were observed. A low rate of mortality (33.3%) was observed in patients who received 3 sessions of hemadsorption. Conclusion: Intermittent hemadsorption reduced inflammatory factors and improved outcomes of patients with severe COVID-19. Cytokine hemadsorption can be an effective therapeutic option for establishing inflammatory equilibrium. Our study was a non-comparator and single-center observational study. Larger studies like RCTs are warranted.

Proteomic analysis of lung responses to SARS-CoV-2 infection in aged non-human primates: clinical and research relevance.

With devastating health and socioeconomic impact worldwide, much work is left to understand the Coronavirus Disease 2019 (COVID-19), with emphasis in the severely affected elderly population. Here, we present a proteomics study of lung tissue obtained from aged vs. young rhesus macaques (Macaca mulatta) and olive baboons (Papio Anubis) infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Using age as a variable, we identified common proteomic profiles in the lungs of aged infected non-human primates (NHPs), including key regulators of immune function, as well as cell and tissue remodeling, and discuss the potential clinical relevance of such parameters. Further, we identified key differences in proteomic profiles between both NHP species, and compared those to what is known about SARS-CoV-2 in humans. Finally, we explored the translatability of these animal models in the context of aging and the human presentation of the COVID-19.

Multi-omic characteristics of longitudinal immune profiling after breakthrough infections caused by Omicron BA.5 sublineages

Omicron sub-variants breakthrough infections (BTIs) have led to millions of coronavirus disease 2019 (COVID-19) cases worldwide. The acute-phase immune status is critical for prognosis, however, the dynamic immune profiling of COVID-19 during the first month after BTIs remains unclear. In this study, we monitored the immune dynamics at various timepoints in a longitudinal cohort during the first month post-BTIs through clinical evaluation, single-cell RNA sequencing (scRNA-seq), T cell receptor (TCR)/B cell receptor (BCR) sequencing, and antibody mass spectrometry. Serological analysis revealed limited impairment to functions of major organs, active cellular and humoral immunity at 2 weeks post-BTI, with significant increases in cytokines (CKs) and neutralizing antibody levels. However, 1 month post-BTI, organ function parameters and CK levels reverted to pre-infection levels, whereas neutralizing antibody levels remained high. Notably, scRNA-seq showed that lymphocytes maintained strong antiviral activity and cell depletion at 2 weeks and 1 month post-BTI, with genes CD81, ABHD17A, CXCR4, DUSP1, etc. upregulated, and genes PFDN5, DYNLRB1, CD52, etc. downregulated, indicating that lymphocytes status take longer to recover to normal levels than that routine blood tests revealed. Additionally, T cell-exhaustion associated genes, including LAG3, TIGIT, PDCD1, CTLA4, HAVCR2, and TOX, were upregulated after BTI. TCRs and BCRs exhibited higher clonotypes, mainly in CD8Tem or plasmablast cells, at 2 weeks post-BTI comparing 1 month. More IgG and IgA-type BCRs were found in the groups of 1 month post-BTI, with higher somatic hypermutation, indicating greater maturity. Verification of monoclonal antibodies corresponding to amplified BCRs highlighted the antigen-specific and broad-spectrum characteristics. Our study elucidated the dynamic immune profiling of individuals after Omicron BA.5 sublineages BTI. Strong immune activation, antiviral response, antibody maturation and class transition at 2 weeks and 1 month after BTI may provide essential insights into pathogenicity, sequential immune status, recovery mechanisms of Omicron sublineage BTI. This study was supported by the National Key R&D Program of China, the China Postdoctoral Science Foundation, Guangdong Basic and Applied Basic Research Foundation, the National Natural Science Foundation of China, CAS Project for Young Scientists in Basic Research, and the Air Force Special Medical Center Science and Technology Booster Program.

Determination of positive end-expiratory pressure in COVID-19-related acute respiratory distress syndrome

BACKGROUND The impact of high positive end-expiratory pressure (PEEP) ventilation and the optimization of PEEP titration in COVID-19-induced acute respiratory distress syndrome (ARDS) continues to be a subject of debate. In this systematic review, we investigated the effects of varying PEEP settings on patients with severe ARDS primarily resulting from COVID-19 (C-ARDS). OBJECTIVES Does higher or lower PEEP improve the outcomes in COVID-19 ARDS? Does individually titrated PEEP lead to better outcomes compared with PEEP set by standardised (low and high ARDS network PEEP tables) approaches? Does the individually set PEEP (best PEEP) differ from PEEP set according to the standardised approaches (low and high ARDS network PEEP tables)? DESIGN Systematic review of observational studies without metaanalysis. DATA SOURCES We performed an extensive systematic literature search in Cochrane COVID-19 Study Register (CCSR), PubMed, Embase.com, Web of Science Core Collection, World Health Organization COVID-19 Global literature on coronavirus disease, World Health Organization International Clinical Trials Registry Platform (ICTRP), medRxiv, Cochrane Central Register of Controlled Trials until 24/01/2024. ELIGIBILITY CRITERIA Ventilated adult patients (≧18 years) with C-ARDS. RESULTS We screened 16 026 records, evaluated 119 full texts, and included 12 studies (n = 1431 patients) in our final data synthesis, none of them being a randomised controlled trial. The heterogeneity of study procedures and populations did not allow conduction of a meta-analysis. The results of those studies that compared lower and higher PEEP strategies in C-ARDS were ambiguous pointing out either positive effects on oxygenation with high levels of PEEP, or negative changes in lung mechanics. CONCLUSION The available evidence does not provide sufficient guidance for recommendations on optimal PEEP settings in C-ARDS. In general, well designed platform studies are needed to answer the questions raised in this review and, in particular, to investigate the use of individualised PEEP titration techniques and the inclusion of patients with different ARDS entities, severities and disease stages. TITLE REGISTRATION Our systematic review protocol was registered with the international prospective register of systematic reviews (PROSPERO 2021: CRD42021260303).

The Sequelae of Sleeping Issues and their Management in Post COVID- 19: A Unani and Contemporary Narrative Review

Background: The Coronavirus disease (COVID-19) impacted not only physical health but also psychological health, including anxiety, depressive symptoms, and sleep issues. Disrupted sleep has now become a global concern and burden in the post-COVID period of recovery. The Unani system of medicine elaborated on sleeping issues and their management during the pandemic. However, the claims of the Unani system and its medications in improving the various domains of sleep quality during the revival period have not been investigated. Materials and Methods: A search of electronic databases on Pub Med, Scopus, Web of Science, and CINAHL, on sleep disorders, post-COVID-19 and a manual search of Unani classical text related to sleep quality improvement methods was conducted. Results: Recent scientific evidence has found a positive association between COVID-19 and sleep disorders. Unani medicine suggests improvement of sleep issues by maintaining six essential factors, dieto-therapy, pharmacotherapy, and regimens (like Nutool (irrigation), Hamam (Turkish bath), and Dalk (massage). Several pre-clinical and clinical trials done on Unani herbs (single and poly-herbal preparations) have elucidated the scientific rationale for improving sleep quality. Conclusion: Unani therapy has sufficient potential for improving sleep outcomes for COVID-19 patients as they are efficacious, safe and affordable therapeutic options. Additionally, there is still a need for evidence to support the validity of Unani psychotherapy as a multifaceted and holistic approach.

Correlation Between Self-reported or Supervised Physical Activity in Noncommunicable Diseases and Comorbidities During COVID-19 Pandemic: A Systematic Review

Abstract Objective The aim of the study is to systematically identify the protective and ameliorative effects of physical activity among people with noncommunicable diseases such as diabetes, cancer, chronic respiratory disease, chronic vascular disease, hypertension, and existing comorbidities during the coronavirus disease (COVID-19) pandemic. Methods The trial is registered in the PROSPERO registry and used the PICO (population, intervention, comparison, and outcomes) strategy to perform the search strategy. Assessors analyzed related studies in the MEDLINE, PROQUEST, PubMed, Cochrane Library, CINAHL, Embase, Google Scholar, Physiotherapy Evidence, and Science Direct databases between December 2022 and January 2023. Researchers independently conducted a quality assessment of each study using a predeveloped quality assessment tool adapted from established tools for quantitative studies. Results Eighteen trials were included (chronic vascular disease–7, diabetes–4, hypertension–1, cancer–3, and chronic respiratory disease–3). The total number of individuals included in the systematic review was 780,003, and the total with or without COVID-19 was 188,435. Qualitative rating by the Newcastle-Ottawa Score for cross-sectional and cohort studies and the Physiotherapy Evidence Database scale revealed fair to good evidence for physical activity as a tool to reduce complications. Conclusions There is evidence that exercise can protect people with noncommunicable diseases during the COVID-19 pandemic. Registration: Registered with Prospero registry

Electrochemical determination of nitazoxanide in environmental and pharmaceutical samples using a boron-doped diamond electrode

Consumption of Nitazoxanide (NTZ), a compound belonging to the class of nitrothiazoles, has increased due to its efficiency in treating viral gastroenteritis caused by rotavirus and norovirus “coronavirus disease”. Thus, developing a method capable of monitoring NTZ in wastewater and pharmaceutical formulations is relevant to human health control. However, most methods for NTZ determination are expensive and time-consuming. Hence, we present a fast, efficient, and low-waste method for NTZ monitoring in drugs and water samples using a boron-doped diamond electrode. A 3D-printed electrochemical cell with a capacity of 2 mL was used for all studies. Besides the simplicity of low waste generation, the method provided good analytical performance with a linear range of 2.0–20.0 µmol/L of NTZ, and a limit of detection (LOD) of 0.57 µmol/L. Recovery percentages between 99 and 107 % were obtained to analyze spiked samples. In addition, we demonstrate that the LOD value can be significantly improved by 50 times after applying a pre-concentration step using solid-phase extraction. Therefore, we believe the described approach is a simple and efficient electrochemical method for monitoring NTZ levels in pharmaceutical and environmental samples without laborious sample preparation procedures. This is the first report to describe the use of BDD electrodes for NTZ monitoring and environmental sample analysis using an eco-friendly approach.

Immunization against COVID-19: A Comprehensive Review on the Leading Vaccines

Abstract: The global impact of coronavirus disease (COVID-19) has prompted researchers and scientists to develop effective vaccines to contain the spread of the pandemic. This has led to the deployment of a range of vaccines from different pharmaceutical companies across the globe in a very short span of time. The current article provides a comprehensive record of all the vaccines developed against coronavirus with a specific focus on the mode of action and administration of the vaccines. The article also dwells on the composition, possible side effects and criteria for the choice of individuals for the administration of the vaccines. Vaccines against COVID-19 have been broadly categorized as mRNA vaccines, adenoviral vector-based vaccines and inactivated vaccines. Among the mRNA vaccines, the Pfizer vaccine and Moderna vaccines gained significant popularity. The Oxford Astro Zeneca vaccine and Sputnik V were the most effective viral vector vaccines. Inactivated vaccines such as Covaxin and Sinovac were also significant contributions to contain the pandemic. The review discusses the efficiency of vaccines against the variants of SARS CoV2. The review will provide a clear-cut idea about all kinds of exciting vaccines against COVID-19. At present, where the immediate crisis of the pandemic has been successfully contained, this article acts as a resource for future public health endeavors, policy makers, health care professionals and the general public to understand the diversity of COVID-19 vaccines.

Risk disclosure and financial performance of Islamic banks in Jordan: the moderating role of financial technology

&lt;p&gt;Risk disclosure (RD) is important to inform investors. However, few studies examined this variable in developing countries and in Islamic bank context. This research investigates how RD affect financial performance (FP) of Islamic banks in Jordan. It also examines the moderating role of financial technology (FinTech). We use a quantitative method to examine how mandatory risk disclosure (MRD) and voluntary risk disclosure (VRD) impact return on assets (ROA) and return on equity (ROE) in Islamic banks operating in Jordan. Our results show that both MRD and VRD have a significant effect on FP of Islamic banks. Moreover, FinTech acts as a moderator in the connection between risk disclosure (MRD and VRD) and FP performance. The effect was compared before and after coronaviruses disease 2019 (COVID-19) and it shows that the COVID-19 has increased the effect of MRD and VRD on FP of Islamic banks. More focus on VRD and MRD will enhance the FP of Islamic banks in Jordan.&lt;/p&gt;

Pharmacological Provocation Test was Less Frequently Performed in Patients with Coronary Spastic Angina Onset during Coronavirus Disease Pandemic: A Multicenter Cross-sectional Study

Pharmacological Provocation Test was Less Frequently Performed in Patients with Coronary Spastic Angina Onset during Coronavirus Disease Pandemic: A Multicenter Cross-sectional Study

Hyaluronan in COVID-19: a matrix for understanding lung disease

ABSTRACT The polysaccharide hyaluronan (HA) is an important component of lung extracellular matrix that increases following infection with influenza or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Hellman et al. (U. Hellman, E. Rosendal, J. Lehrstrand, J. Henriksson, et al., mBio 15:e01303-24, https://doi.org/10.1128/mbio.01303-24 ) show that fragmented HA accumulates in the lungs of coronavirus disease 2019 (COVID-19) patients, with systemic levels of HA being associated with reduced lung function 3–6 months after infection. This study provides novel insights into HA’s role in COVID-19 pathology and its potential utility as a biomarker for disease severity. However, much remains to be understood about the lung HA matrix in COVID-19 and how it compares to other lung conditions. In particular, the role of HA-binding proteins in organizing HA into a crosslinked network is yet to be fully determined at a molecular level. This knowledge is crucial in understanding the inter-relationships between the structure of the HA matrix and the regulation of the immune response, and thus our ability to target HA therapeutically for improved outcomes in COVID-19.

The Association Between COVID-19 Infection Severity and Micronutrient Deficiencies in Children

Background: Coronavirus disease 2019 (COVID-19) can cause pulmonary and systemic inflammation in both children and adults. Investigating the potential impact of micronutrient deficiencies on COVID-19 infection is of great importance. Objectives: This case-control study was designed to compare the serum levels of vitamins D and C and zinc between healthy children and children with mild or severe COVID-19 infection, as well as to investigate the impact of micronutrient deficiencies on the clinical symptoms of patients. Methods: This case-control study was conducted at a teaching hospital in Tehran, Iran. Control subjects were recruited from healthy children, and cases were included from children with mild and severe symptoms of COVID-19. Blood samples were obtained from participants to measure the levels of micronutrients and were analyzed using statistical software. Results: A total of 85 subjects were included (33 controls, 25 cases with mild symptoms, and 27 cases with severe symptoms). We found no differences in the means of serum vitamin D and vitamin C levels between the studied groups. However, the mean serum zinc level was significantly lower in severe patients compared to the controls (P &lt; 0.01). Moreover, no significant difference was observed in the frequency of patients with micronutrient deficiencies based on their clinical conditions. Conclusions: Our findings revealed zinc deficiency in children with severe COVID-19 infection, while no significant differences were found in the mean serum levels of vitamins D and C between healthy children and patients. More studies are necessary to provide more robust evidence.

SARS-CoV-2 surveillance in US wastewater: Leading indicators and data variability analysis in 2023–2024

Wastewater-Based Epidemiology (WBE) has become a powerful tool for assessing disease occurrence in communities. This study investigates the coronavirus disease 2019 (COVID-19) epidemic in the United States during 2023–2024 using wastewater data from 189 wastewater treatment plants in 40 states and the District of Columbia. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and pepper-mild mottle virus normalized SARS-CoV-2 RNA concentration data were compared with COVID-19 hospitalization admission data at both national and state levels. We further investigate temporal features in wastewater viral RNA abundance, with peak timing and cross-correlation lag analyses indicating that wastewater SARS-CoV-2 RNA concentrations precede hospitalization admissions by 2 to 12 days. Lastly, we demonstrate that wastewater treatment plant size has a significant effect on the variability of measured SARS-CoV-2 RNA concentrations. This study highlights the effectiveness of WBE as a non-invasive, timely and resource-efficient disease monitoring strategy, especially in the context of declining COVID-19 clinical reporting.

Global Perspectives on Healthcare Waste Management and Bibliographic Mapping during the Crises of COVID-19

The lack of proper waste management of health care facilities can have a significant negative health impact on the global population. This study provides a critical view on the current state of the existing healthcare waste management practices used in healthcare facilities around the world during the Coronavirus disease 2019 (COVID-19) pandemic outbreak. The increasing amount of COVID-related healthcare waste was analyzed and classified to provide justification for the urgent need to develop waste management standards that ensure safe containment and diversion of hazardous and non-hazardous wastes through recycling, reuse and repurposing. The waste handling, treatment, and disposal management of healthcare waste from various COVID-infected locations such as homes, quarantine centers, camps, and hospitals have been reviewed. A total of 100 documents on COVID-19 related healthcare waste were published on the Web of Science database over the 2020-2022 period. Innovative solutions for effective waste treatment and disposal, related government policies and regulations, and literature survey supported by VOSviewer-aided detailed bibliographic analysis are presented and critically discussed. Thus, the present research output advocates for a paradigm shift towards circular economy principles in healthcare waste management, emphasizing waste reduction, recycling, and recovery, and encourages global cooperation to develop resilient, crisis-responsive waste management systems.

Musculoskeletal Disorders in COVID-19 Surveillance Staff Members: An Analysis of Prevalence, Risk Factors, and Coping Strategies

Aims/Background During the coronavirus disease 2019 (COVID-19) pandemic, the COVID-19 surveillance staff members experienced an increased risk for musculoskeletal disorders. Thus, it is necessary to further investigate the causal factors stemming from COVID-19 surveillance work, especially nucleic acid testing, and establish their relationship with work-related musculoskeletal disorders (WMSDs) by building upon the previous research. This study aimed to determine the prevalence of WMSDs and the major risks faced by the COVID-19 surveillance staff members. Methods This cross-sectional study was conducted in May 2022. The Quick Exposure Check (QEC), Nordic Musculoskeletal Questionnaire (NMQ), and Maslach Burnout Inventory (MBI) were used to evaluate ergonomic factors, musculoskeletal symptoms and pressure among 131 COVID-19 surveillance staff members in four hospitals in South-central Henan Province. Additionally, data regarding the coping strategies adopted by the respondents for lowing the risk of developing WMSDs were collected using a self-report questionnaire. Results The QEC results showed that the back, neck, and should/arm of the COVID-19 surveillance staff members bore high ergonomic loads, while the wrist suffered a medium load. The neck (75.6%), shoulder (66.4%), upper back (58%), and wrist (55.7%) were at higher risk for musculoskeletal disorder. Most of the respondents claimed a low sense of achievement (124, 94.7%) and slightly less than half of them had endured emotional exhaustion at work (61, 46.6%). Prolonged period of maintaining the same posture at work, awkward bending or twisting of back side, task repetition and so on were the perceived job risk factors precipitating WMSDs among the participants in this study. The top three coping strategies for lowering the risk of WMSDs included adjusting the plinth/bed height (49.6%), utilizing different parts of the body at work (47.3%), and taking short breaks when required (33.6%). Conclusion Prolonged large-scale nucleic acid detection can aggravate the musculoskeletal injuries of the neck, shoulder, upper back, and wrist in COVID-19 surveillance staff members. Prevention measures for musculoskeletal injuries factors must be in place to deter such incidence at work.