Coronavirus Disease Research Articles

The Role of Physical Activity in COVID-19 Mortality Rate: A Cross-Sectional Study

Background: Recent evidence suggests a negative correlation between physical activity and the incidence and severity of noncommunicable chronic diseases like cardiovascular disease, diabetes, and respiratory infections. This study explores the potential influence of physical activity levels on the mortality rate and coronavirus disease (COVID-19) recovery. Materials and Methods: This descriptive analytical cross-sectional study evaluated 175 Polymerase Chain Reaction (PCR)–confirmed COVID-19 patients admitted to Baqiyatallah Hospital. The participants’ hospitalization data and physical activity levels were assessed. The Mann–Whitney U test explored the association between physical activity and COVID-19 outcomes. Results: Findings revealed that COVID-19 patients had a mean (SD) physical activity score of 6.55 (1.76) out of a possible 15. The mean scores for physical activity in work, sport, and leisure environments were 2.69 (0.49), 1.37 (1.45), and 2.49 (0.59) out of 5, respectively. Surviving patients exhibited significantly higher sports-specific and overall physical activity levels than those who succumbed to the disease. A Man–Whitney U test results noted statistically significant relationship between total and sports-specific physical activity, hospitalization (interquartile range (IQR) 2.3-3.06, p = 0.020 and IQR 2.5-3, p = 0.010, respectively), and mortality (IQR 0.44-2.75, p = 0.020 and IQR 1.47-2.97, p = 0.020). Conclusions: In summary, increased total physical activity, particularly in a sports environment, appears to be linked with reduced COVID-19 hospitalization and mortality rates.

Kidney replacement therapy trends in end-stage kidney disease patients in South Korea during the COVID-19 pandemic.

The corona virus disease 2019 posed a major risk for end-stage kidney disease (ESKD) cases. Our study aimed to assess changes in kidney replacement therapy (KRT) trends and healthcare access for these patients during the pandemic. We retrospectively analyzed nationwide data from July 2017 to June 2022 to assess changes in KRT and ESKD incidence. KRT modalities included peritoneal dialysis (PD), hemodialysis (HD), and kidney transplantation (KT). We utilized the interrupted time series (ITS) method to compare changes in KRT modality before and after the incidence of the COVID-19 pandemic. ESKD incidence remained stable from 2018 to April 2022. The ITS analysis confirmed that the pandemic did not significant impact overall KRT incidence. PD cases decreased (5.7% to 1.3%), while HD cases increased (81.6% to 85%), and KT recipient remained relatively stable (12.7% to 17.3%). The hospitalization and hospital stay decreased in nursing hospital (165.01 days to 147.77 days) and general hospital (61.34 days to 55.58 days) during the pandemic, however, remained unchanged for PD and KT. Our findings indicate no significant changes in ESKD incidence in South Korea during the pandemic. However, there were shifts in modality distribution, with decreased PD and increased HD cases. Notably, HD cases showed a significant reduction in hospital admissions and length of stay. The healthcare system demonstrated stability during the pandemic, with minimal disruptions in ESKD care.

The Value of Common Laboratory Markers in Predicting the Severity of COVID-19 Patients.

The aim of the present study was to identify more effective laboratory markers to assess the severity of corona virus disease 2019 and predict the progression of the disease by collecting more laboratory markers and variables. In this study, most risk factors, including epidemiological characteristics, blood cell counts, cytokines, and infection markers, were collected from 126 patients with COVID-19 to assess their predictive value. The area under curve (AUC) of Albumin (Alb) to fibrinogen (Fib) ratio (AFR) (0.791), Lactate dehydrogenase (LDH) (0.792), myoglobin (MYO) (0.795), C-reactive protein (CRP) (0.801) and lymphocyte count (0.859) were higher than other markers to distinguish severe from non-severe patients in receiver operating characteristic (ROC) analysis. In the univariate logistic regression analysis, thirty-six out of 46 risk factors, including 34 laboratory markers, were significantly associated with increased odds of severe patients. Multivariate logistic regression analysis showed that the CD19+ lymphocyte count, MYO, LDH, and AFR were associated with increased odds of severe disease. Moreover, Lymphocyte count and AFR levels increased, LDH and CRP levels decreased during hospitalization in recovered severe patients, whereas severe lymphocytopenia and continuously increasing LDH levels were observed in deteriorated patients.AFR level increased and CRP level decreased before the disease worsened in the deteriorated patients; however, when the patients deteriorated, AFR decreased and CRP increased significantly. CD19+ lymphocyte count, MYO, LDH, and AFR are independent biomarkers for early identification of severe COVID-19. Lymphocyte count, AFR, LDH, and CRP levels were helpful in predicting the clinical progression of the disease.\.

Fragment-based Drug Discovery Strategy and its Application to the Design of SARS-CoV-2 Main Protease Inhibitor.

Severe Acute Respiratory Syndrome Coronavirus Type 2 (SARS-CoV-2) emerged at the end of 2019, causing a highly infectious and pathogenic disease known as 2019 coronavirus disease. This disease poses a serious threat to human health and public safety. The SARS-CoV-2 main protease (Mpro) is a highly sought-after target for developing drugs against COVID-19 due to its exceptional specificity. Its crystal structure has been extensively documented. Numerous strategies have been employed in the investigation of Mpro inhibitors. This paper is primarily concerned with Fragment-based Drug Discovery (FBDD), which has emerged as an effective approach to drug design in recent times. Here, we summarize the research on the approach of FBDD and its application in developing inhibitors for SARS-CoV-2 Mpro.

Analysis of Nirmatrelvir Entry into Pulmonary Lining Fluid in Patients with COVID-19: A Unique Perspective to Explore and Understand the Target Plasma Concentration of 292 ng/mL in Antiviral Activity.

Currently, the applicant has chosen a target plasma trough concentration for nirmatrelvir, which is adjusted to 292 ng/mL based on the drug's molecular weight (499.54 Daltons), its binding to human plasma proteins (69%), and the in vitro antiviral EC90 value (181 nM). However, the current exposure-effect relationships (ER) analysis of viral load in patients enrolled in the EPIC-HR study has not revealed clinically significant trends in the ER. Given that the lungs are the primary site of COVID-19 infection, we aim to further understand this exposure relationship by exploring and analyzing the penetration characteristics of nirmatrelvir in the lungs. To explore and understand the target plasma concentration of 292 ng/mL in antiviral activity. We identified all critically ill patients with coronavirus disease 2019 who received nirmatrelvir/ritonavir treatment in the respiratory intensive care unit of Changhai hospital between January 2023 and October 2023. Samples of plasma and bronchoalveolar lavage fluid were obtained at pre-dose trough concentrations after administration of nirmatrelvir (NMV). The relationship between NMV levels in plasma and the epithelial lining fluid (ELF) was assessed by determining concentrations of NMV. There was a significant relationship between NMV levels in plasma and ELF (ELF = 0.4976*PLASMA- 204; R = 0.96), with a correlation whose slope (0.4976) suggested that the blood-to-ELF ratio of drug penetration was 2:1. A negative value from the equation indicates that NMV requires to reach baseline concentration to penetrate the ELF. The relationship between NMV levels in plasma and ELF with low permeability and a negative baseline value suggests that the target plasma concentration of 292 ng/mL is insufficient for antiviral activity. This study provides a unique perspective to explore and understand no clinically meaningful trend of exposure-response relationships in patients enrolled in EPIC-HR.

Challenges and guidance for implementing social distancing for COVID-19 in care homes: a mixed methods rapid review.

Older people living in care homes are at high risk of poor health outcomes and mortality if they contract coronavirus disease 2019. Protective measures include social distancing and isolation, although implementation is challenging. To explore the real-life experiences of social distancing and isolation in care homes for older people, and to develop a toolkit of guidance and resources. A mixed-methods, phased design. Six care homes in England caring for older adults. Care home staff (n = 31), residents (n = 17), family members (n = 17), senior health and care leaders (n = 13). A rapid review to assess the social distancing and isolation measures used by care homes to control the transmission of coronavirus disease 2019 and other infectious diseases (phase 1), in-depth case studies of six care homes, involving remote individual interviews with staff, residents and families, collection of policies, protocols and routinely collected care home data, remote focus groups with senior health and care leaders (phase 2) and stakeholder workshops to co-design the toolkit (phase 3). Interview and focus group data and care home documents were analysed using thematic analysis and care home data using descriptive statistics. The rapid review of 103 records demonstrated limited empirical evidence and the limited nature of policy documentation around social distancing and isolation measures in care homes. The case studies found that social distancing and isolation measures presented moral dilemmas for staff and often were difficult, and sometimes impossible to implement. Social distancing and isolation measures made care homes feel like an institution and denied residents, staff and families of physical touch and other forms of non-verbal communication. This was particularly important for residents with cognitive impairment. Care homes developed new visiting modalities to work around social distancing measures. Residents and families valued the work of care homes to keep residents safe and support remote communication. Social distancing, isolation and related restrictions negatively impacted on residents' physical, psychological, social and cognitive well-being. There were feelings of powerlessness for families whose loved ones had moved into the care home during the pandemic. It was challenging for care homes to capture frequent updates in policy and guidance. Senior health and care leaders shared that the care home sector felt isolated from the National Health Service, communication from government was described as chaotic, and trauma was inflicted on care home staff, residents, families and friends. These multiple data sources have informed the co-design of a toolkit to care for residents, families, friends and care home staff. The review included papers published in English language only. The six care homes had a Care Quality Commission rating of either 'good' or 'outstanding'. There was a lack of ethnic diversity in resident and family participants. Care homes implemented innovative approaches to social distancing and isolation with varying degrees of success. A legacy of learning can help rebuild trust at multiple levels and address trauma-informed care for residents, families, friends and staff. Future work can include evaluation of the toolkit, research to develop a trauma-informed approach to caring for the care home sector and co-designing and evaluating an intervention to enable residents with different needs to transition to living well in a care home. This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR132541) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 45. See the NIHR Funding and Awards website for further award information.

Impact of COVID-19 on the Prevalence and Drug Resistance of Bacteria Isolated From Bacterial Meningitis Cerebrospinal Fluid in Shandong Province: A Multicenter Retrospective Study.

Our objective was to evaluate the ramifications of the 2019 coronavirus disease (COVID-19) pandemic on the microbial profile and antimicrobial resistance patterns of bacteria isolated from cerebrospinal fluid (CSF) specimens of patients with bacterial meningitis. We conducted a retrospective analysis of laboratory results and clinical records about positive CSF cultures reported by the SPARSS network from 2017 to 2023. The study covered three distinct periods: January 2017 to December 2019 (before the COVID-19 pandemic), January 2020 to December 2022 (during the COVID-19 pandemic), and January 2023 to December 2023 (after the COVID-19 pandemic), with a total of 5793 CSF isolates collected. Notably, the proportion of male patients (61.3%) was higher than that of females. After COVID-19, we observed a notable shift in the seasonal peak of CSF pathogens, with a delay of approximately 3 months. Remarkable alterations were evident in both pediatric and adult CSF isolate profiles. In children, the predominant pathogens included coagulase-negative Staphylococcus (CoNS), Streptococcus pneumonia, and Escherichia coli. Notably. After COVID-19, there was a significant decrease in the proportion of CoNS (p = 0.0039) and a notable increase in E. coli (p = 0.0067). In adults, the top three pathogens were CoNS, Acinetobacter baumannii, and Klebsiella pneumoniae. After the pandemic, we observed a significant reduction in the prevalence of A. baumannii (p = 0.0059), while the proportions of K. pneumoniae, Pseudomonas aeruginosa, Enterobacter cloacae, and Enterococcus faecalis increased significantly (p < 0.05). Additionally, among multidrug-resistant bacteria, the detection rate of carbapenem-resistant E. coli escalated (p = 0.0375). Antimicrobial susceptibility analysis indicated a declining trend in resistance rates for CoNS and A. baumannii to certain antibiotics following the pandemic. Conversely, resistance to imipenem in A. baumannii increased. In conclusion, the COVID-19 pandemic has significantly influenced the composition, antimicrobial resistance patterns, and epidemiological dynamics of CSF-isolated bacteria in Shandong province. To effectively address these changes, ongoing and dynamic surveillance of pathogen trends and antimicrobial resistance rate is essential.

Current Updates on Variants of SARS-CoV- 2: Systematic Review.

Coronavirus disease 2019 is caused by the severe acute respiratory syndrome coronavirus 2, which has become a pandemic. Severe acute respiratory syndrome coronavirus 2 is an enveloped, unsegmented, positive-sense, single-stranded RNA virus that belongs to the family Coronaviridae. The objective of this review is to conduct a qualitative analysis of the current updates on epidemiology, evolution, and vaccine variants for SARS-CoV-2. The search strategy was done from the database based on the PRISMA criteria for qualitative analysis of this review. Literature on variants of severe acute respiratory syndrome coronavirus 2, published in English in the last 5 years (2019-2023), were included. From 179 a total of 105 articles were reviewed, searched, and retrieved from the electronic databases PubMed. The search was done using keywords like COVID-19, SARS-CoV-2, variants, mutations, and vaccines, and articles were managed using EndNote X8 software. The scope of view for this review was the course of the pandemic by emerging variants and how man is struggling to overcome this sudden pandemic through vaccines. The narrative skeleton was constructed based on the article's scope of view. From the parent severe acute respiratory syndrome coronavirus 2, many variants emerged during the course of this pandemic. They are mainly categorized into two variants: variants of interest and variants of concern based on the impact on public health. The World Health Organization leveled five variants: Alpha (strain B.1.1.7), Beta (strain B.1.351), Gamma (strain P.1), Delta (strain B.1.617.2), and Omicron (B.1.1.529). It is crucial to stay informed about the latest developments in the understanding of SARS-CoV-2 variants, as new variants can emerge and impact the course of the pandemic. Health authorities and researchers continuously have to monitor and study these variants to assess their characteristics, transmissibility, severity, and the effectiveness of vaccines against them. One has to always refer to the latest information from reputable health journals or organizations for the most up-to-date and accurate details on COVID-19 variants.

The Impact of the COVID-19 Pandemic on Taxpayers in Nigeria

There is no doubt that the outbreak of the Coronavirus disease (COVID-19) strikes the world with unparalleled disruption in economic and business activities. The impacts of the COVID-19 pandemic have dealt a serious blow to businesses, households, individuals, and revenue generation by governments across the globe with Nigeria being no exception. As a result, Nigeria introduced certain tax measures through the Emergency Economic Stimulus Bill 2020 to mitigate the impact of the pandemic on taxpayers but these measures are inadequate and in some ways impracticable. The measure includes a temporary relief to companies and individuals to alleviate the adverse financial consequences of a slowdown in economic activities as a result of the COVID-19 pandemic. The article argues that it is clear that the COVID-19 pandemic has drastically reduced business activities and the Bill does nothing to reduce or remove the existing tax burden but simply postpones the same to a later date. This negates section 14(2)(b) of the Nigerian Constitution 1999 as amended which provides that the security and welfare of the people shall be the primary purpose of government. This raises a critical question as to whether revenue generation by the Nigerian government is more important than preventing hardships and reducing the burden of Nigerian taxpayers whose welfare the government has sworn to protect through the Constitution. The implication is that the Nigerian government needs to revise its tax regime encompassing incentives such as tax credits, write-offs, and tax holidays in a bid to provide adequate relief to the taxpayers pending the eradication of the pandemic and a return to economic stability.

Fullerenol C60(OH)40 Nanoparticles and Ectoine Protect Human Nasal Epithelial Cells Against the Cytokine Storm After Addition of the Full-Length Spike Protein from SARS-CoV-2.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters the nasal cavity, penetrates the nasal epithelial cells through the interaction of its spike protein with the host cell receptor angiotensin-converting enzyme 2 (ACE2) and then triggers a cytokine storm. We aimed to assess the biocompatibility of fullerenol nanoparticles C60(OH)40 and ectoine, and to document their effect on the protection of primary human nasal epithelial cells (HNEpCs) against the effects of interaction with the fragment of virus - spike protein. This preliminary research is the first step towards the construction of a intranasal medical device with a protective, mechanical function against SARS-CoV-2 similar to that of personal protective equipment (eg masks). We used HNEpCs and the full-length spike protein from SARS-CoV-2 to mimic the first stage of virus infection. We assessed cell viability with the XTT assay and a spectrophotometer. May-Grünwald Giemsa and periodic acid-Schiff staining served to evaluate HNEpC morphology. We assessed reactive oxygen species (ROS) production by using 2',7'-dichlorofluorescin diacetate and commercial kit. Finally, we employed reverse transcription polymerase chain reaction, Western blotting and confocal microscopy to determine the expression of angiotensin-converting enzyme 2 (ACE2) and inflammatory cytokines. There was normal morphology and unchanged viability of HNEpCs after incubation with 10 mg/L C60(OH)40, 0.2% ectoine or their composite for 24h. The spike protein exerted cytotoxicity via ROS production. Preincubation with the composite protected HNEpCs against the interaction between the spike protein and the host membrane and prevented the production of key cytokines characteristic of severe coronavirus disease 2019, including interleukin 6 and 8, monocyte chemotactic protein 1 and 2, tissue inhibitor of metalloproteinases 2 and macrophage colony-stimulating factor. In the future, the combination of fullerenol and ectoine may be used to prevent viral infections as an intranasal medical device for people with reduced immunity and damaged mucous membrane.

Effect of a Structured Tele Based Post COVID-19 Rehabilitation Program in the Indian Population.

Introduction: The emergence of coronavirus disease of 2019 (COVID-19) and the imperative for social distancing have propelled telehealth to the forefront. Even after discharge, patients may experience lingering symptoms, termed post-COVID-19 syndrome, which impairs functioning. This syndrome persists beyond recovery from COVID-19. Hence, timely implementation and sustained access to pulmonary rehabilitation services are crucial for COVID-19 patients. This study aims to assess the impact of a structured telerehabilitation program on post-COVID-19 recovery in the Indian population. Methodology: A total of 53 patients, with their informed consent, were included in the study, comprising 71.7% males and 24.3% females, with a mean age of 57.15 years (SD = 11.74, range: 30-81 years). Upon enrollment, comprehensive assessments were conducted, incorporating the visual analog scale (VAS) score for fatigue, 1-minute sit-to-stand test, post-COVID-19 functional status scale, and Depression, Anxiety, and Stress Scale-21 (DASS-21). Treatment interventions were administered remotely via WhatsApp video or Zoom calls, consisting of pulmonary rehabilitation protocols encompassing warm-up exercises, breathing exercises, aerobic and strength training, yoga, cooldown exercises, and regular educational sessions tailored to individual patient needs. Results: There was a significant improvement in outcome measures: VAS score for fatigue (t = 8.6, S, p < 0.001), 1-minute sit-to-stand (steps: t = 5.9, S, p < 0.001), and health-related quality of life (Z = 5.9, S, p < 0.001). Conclusion: The study shows that a structured tele-based program is not only effective in patients but also an approach that is feasible and should be considered for the delivery of rehabilitation to patients who are unable to participate in center-based rehabilitation.

A Retrospective Observational Study to Compare the Clinical and Laboratory Parameters of Patients Requiring Hospitalization during 3rd Wave vs 2nd Wave of Coronavirus Disease 2019.

Background: Following the outbreak of coronavirus in Wuhan, China in 2019, there has been multiple waves of different variants of COVID-19 throughout the world in the continuum of a pandemic. This study aims to compare different clinical and laboratory parameters of hospitalized patients in Omicron-driven 3rd wave vs Delta-driven 2nd wave in India. Materials and methods: This was a retrospective cross-sectional observational study that was done in the Department of General Medicine, Mahatma Gandhi Hospital, Dr S N Medical College, Jodhpur (Rajasthan). It included 100 patients of 3rd wave and 2nd wave respectively who were hospitalized. The primary outcome of the study was patient's survival and condition at discharge and secondary outcomes included length of hospital stay and mode of oxygenation. Results: The presence of cough, shortness of breath, and loss of taste are more common symptoms in 2nd wave vs 3rd wave with p-value being 0.0002, 0.004, and < 0.0001 respectively. The severity of illness, need for intensive care unit (ICU), and outcome in terms of discharge with oxygen or without oxygen were also statistically significant in the 2nd wave vs 3rd wave with p-value being < 0.0001 for all three variables. A total of 67% of patients were vaccinated in 3rd wave group compared to 11% in 2nd wave group (p-value < 0.0001). Comparison of laboratory parameters also revealed statistically significant results with D-dimer, quantitative C-reactive protein (CRP), normal (NL) ratio, and serum lactate being more deranged in the 2nd wave compared to the 3rd wave with p-value being < 0.05. Comparison of involvement of lung parenchyma based on computed tomography (CT) severity score revealed p-value < 0.0001 that is statistically relevant. Conclusion: Omicron-driven 3rd wave was associated with significantly less severity, less inflammatory response, and better outcome compared to Delta-driven 2nd wave. More vaccination and probably less intrinsic virulence during 3rd wave has a major role in the better outcome.

A self-efficacy enhancement alcohol reduction intervention for men on-remand in prison: the APPRAISE feasibility pilot RCT.

As many as 70% of remand prisoners have admitted to being under the influence of alcohol when committing the crime leading to their imprisonment. Providing support and advice regarding alcohol consumption can be effective in some groups of people. There is little evidence regarding this for men on remand in prison. To pilot the study measures and evaluation methods to assess the feasibility of conducting a future definitive multicentre, pragmatic, parallel group, randomised controlled trial. A two-arm, parallel group, individually randomised pilot study of a self-efficacy-enhancing psychosocial alcohol intervention to reduce levels of alcohol consumption for males on remand in prison and on liberation. Two purposively selected prisons in Scotland and England. Adult men on remand in prison with an Alcohol Use Disorders Identification Test score of ≥8. The APPRAISE intervention delivery comprised four steps: Step 1: 1×40-minute face-to-face session, delivered by a trained practitioner from Change Grow Live in prison. Steps 2, 3 and 4: 20-minute sessions conducted by phone, on or as close as possible to days 3, 7 and 21 post liberation. Control: assessment, screening and referral onto further alcohol support options. Recruitment and retention rates, completion of follow-ups, outcome measures at 12 months and interventions delivered. The primary outcome for the pilot study was alcohol consumed in the 28 days prior to Time Point 2, assessed using the extended Alcohol Use Disorders Identification Test-C. Of 182 men on remand approached across two study sites, 132 were randomised (90 in England; 42 in Scotland) with 46 randomised to intervention and 44 to care as usual in England and 22 randomised to intervention and 20 to care as usual in Scotland. A total of 53 in-prison interventions were delivered. One day-3 post-liberation intervention was delivered, no day-7 and one day-21. At 12 months, of 132 randomised, 18 (13%) were followed up, 53 (40%) were not liberated; 47 (36%) were uncontactable and 14 (11%) had been released but could not be located. Data completeness was 96% at baseline and 8% at 12 months. The process evaluation reported good acceptability of the intervention with investment in time, capacity and space to support implementation identified. The economic study produced guidance on how to assess costs associated with implementing the APPRAISE intervention which could be applied more broadly. No adverse events or side effects were noted. A future definitive trial would be possible, but only if follow-up mechanisms can be addressed as well as full access to recidivism and health data. Collaboration with the probation service in future could offer the opportunity to develop a robust process and system to optimise follow-up post liberation. Dedicated resources to support the intervention delivery both in and out of the prison setting are recommended. Coronavirus disease discovered in 2019 impacted recruitment and follow-up, with access to prisons restricted. We were unable to deliver the post-liberation element of the intervention. We did not include probation services or other agencies in the trial. This trial is registered as Current Controlled Trials ISRCTN36066. This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 17/44/11) and is published in full in Public Health Research; Vol. 12, No. 11. See the NIHR Funding and Awards website for further award information.

A Study of the Progression, Complications, and Outcome of Mucormycosis in a Case of Coronavirus Disease 2019 Pneumonitis at a Tertiary Care Hospital in Gujarat.

Introduction: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused coronavirus disease 2019 (COVID-19) has been connected to numerous opportunistic bacterial and fungal infections. Mucormycosis is a fatal opportunistic disease that became much more common with the second COVID-19 wave. We plan to look into the prognosis and course of mucormycosis following COVID-19, as well as the risk of mucormycosis in cases with COVID-19 pneumonitis. Materials and methods: Just 100 verified cases of mucormycosis that were admitted to a civil hospital in Rajkot between April 2021 and March 2022 were included in this retrospective cross-sectional investigation. Data gathered from medical records included diagnoses, vital signs, test findings, microbiological information, usage of antibiotics, and outcomes. After entering the data into Microsoft Excel, we performed analysis and computations to determine frequency, percentage, and the Chi-squared test for variable comparison. Results: About 77.0% of the 100 mucormycosis patients were between the ages of 41 and 70. The bulk of them were male. The most frequent associated comorbidity was diabetes mellitus (DM) (30.0%). The most commonly impacted sinuses were the maxillary and ethmoidal ones. Amphotericin B was administered intravenously to each patient. In total, 82.0% of patients survived while 18.0% of patients died. Conclusion: Mucormycosis is an extremely rare, serious, and sometimes fatal infection. Because of comorbidities like diabetes and smoking, it went up with COVID-19. The use of glucocorticoids during COVID-19 treatment was the main risk factor.

Veterinary students' perceptions toward incorporating and expanding telehealth service delivery knowledge in curricula and future practice: a cross-sectional study.

Telehealth is the use of technology to deliver medical services. Potential uses among veterinarians include consulting with specialists about complicated cases, sending in electronic prescriptions, or meeting with clients to discuss patient health. Although the coronavirus disease 2019 pandemic posed many challenges to the veterinary profession, it accelerated the adoption of telehealth among veterinarians. As many of these changes took place quickly in response to the pandemic, many of those in practice did not receive much training or guidance; therefore, this study explores veterinary students' perceptions regarding incorporating telehealth into the veterinary curriculum and the utilization of telehealth in the future. An email survey was sent to students at a veterinary school. 80 students provided answers to the 11-question survey. Nearly 80% reported that it is either "important" or "very important" to incorporate telehealth training into the veterinarian curriculum, whereas almost 90% indicated that they would benefit from more telemedicine training prior to graduation. Almost 75% of participants had legal and malpractice concerns, which may present a barrier to using the technology upon graduation. This study suggests that veterinary schools should explore how to incorporate telehealth training into their curriculum, especially in regard to navigating the potential pitfalls that may be encountered when employing telehealth within the context of a veterinarian-client-patient relationship. Telehealth is a valuable tool, and its use has become commonplace. Educational programs that emphasize telehealth will better equip future clinicians to manage the nuances of this modality in practice.

Telemedicine for long-term continuous positive airway pressure therapy: A six-month follow-up study in Japan using propensity score matching

BackgroundDuring the coronavirus disease (COVID-19) pandemic, Japan's health insurance system allowed continuous positive airway pressure (CPAP) telephone consultations to extend clinic visit intervals. This study aimed to determine whether 6-month CPAP adherence in the telemedicine (TM) group was inferior to that in the standard care group. MethodsPatients receiving long-term CPAP therapy for at least 6 months for obstructive sleep apnea (OSA) from two clinics in Japan were recruited between May and July 2020. The TM group consisted of patients who had not visited the clinic in person for 6 months, with physicians providing telephone consultations every 1–2 months. The standard care group included patients who visited the clinic monthly for physician consultation. In both groups, physicians reviewed CPAP usage data via telemonitoring. Patients were classified into three groups according to change in adherence: ≤ −5%, > −5 to <5%, and ≥5%. The primary outcome was the number of patients with worsened CPAP adherence (≤−5%). ResultsOf the 479 patients in the TM group and 146 in the standard care group, 120 were matched using propensity score 1:1 nearest neighbor matching and selected from both groups. Adherence worsened in 41 (34.2%) and 32 (26.7 %) patients in the TM and standard care groups, respectively. The TM group was not inferior to the standard care group in terms of the proportion of patients with worsened CPAP adherence (χ2 = 1.81, df = 1, P = 0.178). ConclusionsThis study found no significant difference in the 6-month CPAP adherence between the TM and standard care groups.

Translated knowledge: the production of marginalization of the Roma during the COVID-19 pandemic

Abstract This research evaluates news during the first year of the coronavirus disease 2019 pandemic in order to examine how European publics made sense of the Roma, the largest and most marginalized ethnic community on the continent. Based on the analysis of news in English, French, Italian, and Romanian, the study finds that much of the coverage across national and cultural boundaries translated marginalization, already exacerbated by the health crisis, through familiar lenses of blame and backwardness. Whereas anti-ethnic discrimination was primarily recognized in news reliant on official, governmental sources, news in French and Italian chiefly circulated representations of otherness. Romanian news revealed both systemic racism and community solutions, also filtered through a discriminatory lens. Translating justice- or equity-oriented content—directly or ideologically—appeared incomplete, infrequent, and often filtered through bias. The tool of local and regional translation emerged as central to the circulation of ideas across the continent.

Utilization of Probiotic-Derived Extracellular Vesicles as Postbiotics and Their Role in Mental Health Therapeutics.

As consumers become more interested in healthier lifestyles, the global functional food market is expanding. Probiotics have gained attention because of their numerous health benefits to the host and may even treat various pathological conditions. Probiotics interact with host cells, and particularly, probiotics-derived extracellular vesicles (PEVs) are key factors in the health benefits of probiotics. Additionally, extracellular vesicles are nano-scaled lipid-bilayer particles that carry various biological molecules, indicating potential as new postbiotics that can provide the same health benefits as probiotics while complementing the side effects associated with probiotics. The importance of mental health care is becoming increasingly prominent considering societal conditions, such as the recent aging population and the coronavirus disease 2019 pandemic. However, the response to mental health issues among modern individuals is insufficient, and there is a need for the development of new personalized treatments to overcome the limitations of current mental health therapies. PEVs have various physiological functions, including mediating cellular communication in the central nervous system, which indicates associations among mental disorders. Therefore, we focused on the beneficial effects of PEVs on the brain and mental health. Recent research has shown that PEVs can adjust the expression of brain-derived neurotrophic factors in vitro and in vivo, demonstrating antidepressant and cognitive function improvement effects. This suggests that PEVs have potential as therapeutic agents for improving mental health and treating brain disorders. Based on this, we review these findings and present the beneficial effects of PEVs on mental health and the challenges that need to be addressed.

Gynecologic Pathology Journal Club: A 2-year, Worldwide Virtual Learning Experience With a Focus on Mentorship and Inclusion.

Journal clubs (JCs) are a common format used in teaching institutions to promote trainee engagement and develop skills in seeking out evidence-based medicine and critically evaluating literature. Digital technology has made JC accessible to worldwide audiences, which allows for increased inclusion of globally diverse presenters and attendees. Herein we describe the experience of the first 2 years of a virtual gynecologic pathology JC designed with the goal of providing mentorship and increasing inclusivity. JC began in a virtual format in April 2020 in response to the need for remote learning during the coronavirus disease 2019 pandemic. Each JC had 1 moderator, lasted 1 hour, featured up to 3 trainees/early-career pathologists, and covered articles on gynecologic surgical pathology/cytopathology. Trainees were recruited through direct contact with moderators and advertising through social media (eg, Twitter). A template was used for all presentations, and before presenting, live practice sessions were conducted with the moderator providing constructive feedback and evaluations were provided to presenters and attendees for feedback. Recordings of the meetings were made publicly available after the event through YouTube, a society website, and emails to registrants. Fifty-nine presenters participated, covering 71 articles. Most were trainees (53/59; 89%) from North America (33/59; 56%), with additional presenters from Asia (14/59; 24%), Australia/Oceania (5/59; 8%), Africa (4/59; 7%), and Europe (3/59; 5%). An average of 20 hours were spent per month by moderators on the selection of papers, meeting preparation, and provision of mentorship/feedback. Live events had a total of 827 attendees, and 16,138 interactions with the recordings were noted. Among those who self-identified on provided surveys, the attendees were most commonly from Europe (107/290; 37%) and were overwhelmingly practicing pathologists (275/341; 81%). The experience, including mentorship, format, and content, was positively reviewed by attendees and presenters. Virtual JC is an inclusive educational opportunity to engage trainees and early-career pathologists from around the world. The format allowed for the JC to be widely viewed by attendees from multiple countries, most being practicing pathologists. Based on feedback received, virtual JC appears to expand the medical knowledge of the attendees and empower presenters to develop their expertise and communication skills.

Extracellular vesicles containing SARS-CoV-2 proteins are associated with multi-organ dysfunction and worse outcomes in patients with severe COVID-19.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) and has been related to more than 7 million deaths globally since 2019. The association of high levels of IL-6 with severe cases led to the early evaluation of the anti-IL6 inhibitor tocilizumab as a potential treatment, which unfortunately failed to improve survival in many trials. Moreover, little is known about the development of COVID-19 sequelae, and biomarkers are needed to understand and anticipate these processes. Because extracellular vesicles (EVs) play an important role in viral infection and immune response, they could potentially serve as predictive and prognostic biomarkers. We isolated EVs from 39 patients with severe COVID-19, from which 29 received tocilizumab and 10 were considered controls. Blood samples, which were collected at hospitalisation before treatment, at Day 7, and Day 15 during follow-up, were assessed by immunoblot for longitudinal expression of spike (S) and nucleocapsid (N) proteins. Dynamic expression was calculated and compared with clinicopathological and experimental variables. Expression of EV S was validated by immunogold and imaging flow-cytometry, revealing an enrichment in CD9+ EVs. As a result, decreasing expression of EV viral proteins was observed in patients treated with tocilizumab. Moreover, higher increase in EV S was observed in patients with lower antibody response, hyperfibrinogenemia, lower respiratory function, higher blood pressure and shorter outcomes. These findings lay the foundation for future studies characterizing the role of EVs in multiorgan assessment and identifying biomarkers in patients with severe COVID-19 and possible long COVID.