Coronavirus Disease 2019 Infection Research Articles

Clinical Characteristics and Prognosis in Allergic Health Workers Patients with COVID-19 Infection

Background: After a case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported in Wuhan, China, at the end of 2019, the cause of coronavirus disease 2019 (COVID-19) was soon recognized as a global public health emergency. Objectives: This study aimed to investigate the clinical characteristics of allergic healthcare workers (HCWs) confirmed to have COVID-19. Methods: This study included 30 HCWs with confirmed COVID-19 at Kosar Hospital in Semnan, Iran, from February to June 2020 (15 allergic and 15 non-allergic individuals). Demographic data, clinical manifestations, and laboratory findings of the subjects were recorded. Results: Total IgE, allergen-specific IgE, and anti-SARS-CoV IgG were measured in the patients' serum. The average age of the allergic and non-allergic HCWs with COVID-19 was 33 years, and 80% were female. Malaise (76.6%), fever (60%), weakness (60%), and dry cough (56.7%) were the most common symptoms. The clinical findings showed a significantly lower percentage (33.3%) of dry cough in subjects with allergic diseases. Apart from the observed difference in the mean value of total IgE between the two groups, no significant differences were found with respect to age, duration of disease, O2 saturation, and anti-SARS-CoV-2 IgG. Conclusions: Coronavirus disease 2019 symptoms did not become severe in patients with atopic diseases. Moreover, dry cough and weakness were reported by a lower percentage of allergic HCWs.

Factors influencing the time to COVID-19 antigen tests negative conversion among students at a Chinese university: a retrospective analysis

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause repeated infections. China experienced an outbreak of COVID-19 (coronavirus disease 2019) after the Chinese government changed its COVID-19 policy in December 2022. However, little is known about the influencing factors, such as a history of previous infection and vaccine dose, and whether these factors affect the time at which the antigen test results become negative for SARS-CoV-2. Boarding colleges and universities are prone to outbreaks caused by COVID-19. Therefore, we investigated the factors influencing the time of COVID-19 antigen tests conversion at one university from April to June 2023.MethodsThis study included college students from one university in Guangzhou who tested positive for the COVID-19 antigen and collected information such as sex, history of previous COVID-19 infection, vaccination dose, symptom onset date, and antigen tests conversion date for retrospective analysis. Chi-square tests or t-tests were used to compare differences between groups.ResultsA total of 255 college students were included in this study. In addition to fever, the most common symptoms were sore throat, nasal symptoms and fatigue. The average time to antigen tests negative conversion of patients with their first infection was 6.12 ± 1.83 days, and that of patients with their second infection was 4.70 ± 1.43 days. The difference between the groups was statistically significant (P < 0.001). The average time to antigen tests negative conversion was 6.21 ± 1.92 days in patients with more than 3 symptoms except fever, which was significantly greater than that in patients with 0–1 (5.54 ± 1.79 days) or 2–3 symptoms (5.45 ± 1.78 days) (P < 0.05). There was no significant difference in time to antigen tests negative conversion according to sex, health observation location or vaccination dose (P > 0.05).ConclusionIn college students, a history of SARS-CoV-2 infection as well as the number of symptoms were significantly associated with the time to COVID-19 antigen tests conversion.

DEEP LEARNING FOR MULTI-LEVEL SEVERITY CLASSIFICATION OF COVID-19 USING CT IMAGES

Coronavirus disease 2019 (COVID-19) was witnessed in the year 2019 and is termed a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the World Health Organization (WHO). The preceding investigations recommended that computer tomography (CT) images comprise numerous potential indicators of infection. However, the infection may be distinct to COVID-19 which represents various difficulties for radiologists in particularly recognizing COVID-19 infections employing CT images. To bridge this gap, a multi-level severity classification for COVID-19 with fractional hunger game search optimization (FHGSO)-enabled deep max out network (DMN) employing CT images is developed. The input CT scan is allowed to the pre-processing phase conducted employing an Adaptive median filter. After that, Lung lobe segmentation is performed by deep joint segmentation. Thereafter, the image augmentation is conducted based on translation, rotation, flipping and scaling. Additionally, the augmented image is subjected to feature extraction. COVID-19’s first level classification is categorized into normal and abnormal employing deep Q-network (DQN) that is tuned by proposed exponential snake war strategy optimization (ESWSO) is obtained by the incorporation of war strategy optimization (WSO) and snake optimization (SO). If it is abnormal, the second level classification is accomplished where the disease is classified into mild, moderate and severe, which is done by DMN, trained by proposed fractional hunger game search (FHGSO) optimization, where FHGSO is obtained by the combination of hunger game search (HGS) and fractional concept. The analysis metrics employed for FHGSO_DMN are accuracy, sensitivity, and specificity achieving the maximum of 94.70%, 95.70%, and 82.70%.

Clinical characteristics and prognostic factors of COVID-19 in rheumatic patients and their family members: a retrospective study

BackgroundPatients with rheumatic diseases who receive long-term treatment with steroids, immunosuppressants, or biologics are more susceptible to infection with pathogens than the general population. In order to explore the differences in clinical features and prognosis of Corona Virus Disease 2019 (COVID-19) infection between patients with rheumatic diseases and the general population (family members), a retrospective investigative study was used to analyze the differences between the two populations.MethodsThe study was conducted in 13 Grade A Tertiary hospitals in China to investigate the clinical symptoms and prognostic factors of patients with rheumatic diseases who were infected with COVID-19 for the first time and their families.ResultsA total of 2,889 participants were included in this study, including 1,530 patients with rheumatic diseases and 1,359 family members. In terms of clinical symptoms, the complete recovery time from COVID-19 for patients with rheumatic disease patients was 13 days (8.00, 18.00), which was shorter than that of family members (16 days, 11.00, 20.00). The risk of developing moderate to severe cases of COVID-19 was lower in patients with rheumatic disease than in their family members (OR=0.511, P=0.0026). Compared with non-use of non-steroidal anti-inflammatory drugs (NSAIDs), the risk of developing mild cases of COVID-19 was 0.595 times greater with pre-infection use of NSAIDs (P = 0.0003). The use of glucocorticoids and Chinese herbal decoctions before infection increased the probability of developing mild cases of COVID-19 (OR=1.537, 1.773, P&amp;lt;0.05). The risk of developing moderate to severe cases with disease-modifying anti-rheumatic drugs (DMARDs) used before infection was 0.350 times that without such drugs (P&amp;lt;0.001). In terms of prognosis, compared with family members, the complete recovery time of patients with rheumatic diseases was reduced by 2.241 days on average (P&amp;lt;0.001), and the complete recovery time of patients with mild rheumatism was reduced by 4.178 days on average (P&amp;lt;0.001). There was no significant difference in the complete recovery time from COVID-19 in patients with severe rheumatism compared with their family members (P=0.1672). The use of NSAIDs, glucocorticoids, DMARDs, biologics, Chinese patent medicine, and Chinese herbal decoctions during the infection period could shorten the recovery time of COVID-19 symptoms (P&amp;lt;0.05).ConclusionsCompared with their family members, patients with rheumatic diseases had milder symptoms after infection with COVID-19, which was related to the use of glucocorticoids, DMARDs, and Chinese herbal decoctions before infection. During the COVID-19 infection phase, the use of NSAIDs, glucocorticoids, DMARDs, biologics, Chinese patent medicine, and Chinese herbal decoctions might shorten the recovery time from symptoms of COVID-19.Chinese clinical trial registryChiCTR2300072679

Exploring the association of social isolation and loneliness on the experience of COVID-19 infection and hospitalization in the Japanese population: the JACSIS study.

Social isolation and loneliness have been long-standing public health concerns, and the coronavirus disease 2019 (COVID-19) pandemic has exacerbated these issues. Therefore, this study aimed to investigate the associations of social isolation and loneliness during the pandemic with experience of COVID-19 infection and hospitalization in the Japanese population. Data were sourced from the Japan COVID-19 and Society Internet Survey (JACSIS), a large-scale, web-based national survey of individuals aged 15-79. This study used JACSIS data from 2020 to 2022, representing the first and third years of the pandemic. Social isolation was measured by the frequency of direct and indirect contact with people other than co-residing family members. Loneliness was evaluated using the UCLA Loneliness Scale, while COVID-19 infection and hospitalization were self-reported. A total of 13,612 individuals were included, of whom 1.5% had experienced hospital admission due to COVID-19, and 9.3% were infected but not hospitalized. Social isolation was inversely associated with COVID-19 infection risk (odds ratio = 0.77; 95% confidence interval: 0.66-0.90), while a higher level of loneliness was related to hospitalization (odds ratio = 2.21; 95% confidence interval: 1.59-3.09). Sex-stratified analyses revealed stronger associations in men than women. This study highlights the complex relationship between psychosocial factors and infectious disease outcomes, underscoring the need for comprehensive approaches to address the multifaceted challenges posed by global health crises.

Evaluation of joint external evaluation to COVID-19 and other infectious diseases mortality outcomes in 96 countries

Abstract Background This study evaluated the effectiveness of Joint External Evaluation (JEE) scores with regard to coronavirus disease 2019 (COVID-19) and other infectious diseases performance in 96 countries. To propose a revised JEE tool, potential JEE indicators were also examined. Methods JEE data from 2016–2019 were linked with outcomes such as COVID-19 fatality rates and infections, as well as mortality rates for other infectious diseases. We also examined potential indicators such as the Sustainable Development Goals (SDGs) and Universal Health Coverage index to propose enhancements to the JEE tool. Multiple regression analysis was used to assess these associations. Results The average JEE score was 2.70 (SD=0.92) in 96 countries. Detection capabilities received the highest average score (3.23), while the other areas (2.30) section received the lowest scores. However, the analysis revealed that the JEE tool had limited predictive accuracy for COVID-19 outcomes. By contrast, the JEE scores showed a negative association with the performance of other infectious diseases. Notably, SDGs 2 (zero hunger), 4 (quality education) and 8 (decent work and economic growth) were strongly associated with better COVID-19 outcomes. Conclusion The JEE scores showed limited predictive value for COVID-19 mortality outcomes in 96 countries. The tool offers insights into health security, but needs revision to better handle future pandemics.

Work experience of special workers returning to work after the public health emergency: taking ICU nurses who have been infected with COVID-19 as example†

Abstract Objective The occurrence of some public health events inevitably endangers medical personnel, and medical personnel, as a special group, have to resume work on time to treat patients. This coronavirus disease-2019 (COVID-19) infection is a good example, and what intensive care unit (ICU) nurses experience as the primary caregivers of critically ill patients after COVID-19 infection is our focus. To explore the work experience of ICU nurses after recovery from COVID-19, and to provide a theoretical basis for the intervention to improve the physical and mental health level and work experience of special workers in public health emergencies. Methods We conducted an explorative descriptive study using an inductive thematic analysis. Using the maximum differential sampling method, a semi-structured interview was conducted among 13 ICU nurses suffered from COVID-19 in a tertiary grade A hospital in Qingdao, Shandong Province. This study carried on the theme analysis according to the inductive content analysis method and used MAXQDA 2020 Analytics Pro (VERBI Software GmbH, Berlin, Germany) to manage and summarize the interview data. Results After being infected by the virus, SARS-Coronavirus-2 (SARS-CoV-2), the pathogen of COVID-19, the work experience of ICU nurses was extracted from the following 5 themes: (1) Stress and challenge caused by the change of work focus; (2) downsizing, overtime, taking up work with illness, and physical discomfort; (3) dedication and family debt; (4) unknown fear and helplessness; and (5) professional responsibility and sense of benefit. Conclusions Under the pressure of COVID-19, ICU nurses face multiple pressures and challenges, and their emotions are complex. We suggest that nursing managers should take corresponding measures to alleviate nurses’ physical and psychological pressure and improve their work experience.

The Triad of COVID-19 in Children: Acute COVID-19, Multisystem Inflammatory Syndrome, and Long COVID-Part I.

The coronavirus disease 2019 (COVID-19) originated in Wuhan, China, in late 2019. Within a span of a few months, it was deemed a global pandemic by the World Health Organization. It was first thought to affect the adult population, but soon after, cases of COVID-19 in children started emerging. As more and more pediatric cases started unveiling, an entity called multisystem inflammatory syndrome in children (MIS-C) that replicated Kawasaki disease was established. More recently, it has been noted that children have persistent symptoms for weeks or months after acute COVID-19 infection, and the term coined for these symptoms is "long COVID." This section of the review will summarize the respiratory, cardiovascular, dermatological, and gastroenterological manifestations noted in infants in three broad categories: acute COVID, MIS-C, and long COVID. [Pediatr Ann. 2024;53(12):e473-e477.].

Relationship between ABO Blood Groups and Rh Factor with COVID-19 in Nineveh Governorate

ABO blood types and the Rh factor have recently been linked to an increased risk of developing the pandemic coronavirus disease 2019 (COVID-19) in individuals of different ethnic backgrounds. The conducted current study aimed to comprehend the relationship between this polymorphic apparatus and illness risk in Nineveh patients and healthy individuals. Recovery or death and two COVID-19 outcomes were also investigated. Many individuals including COVID-19 Nineveh patients had their ABO blood type and Rh factors determined. Thus, four groups (under therapy, rehabilitative, death, and healthy donors) were created from the research samples. The diagnosis kit RNA (PCR-Fluorescence Probing) was used to diagnose 2019 novel coronavirus (2019nCoV) for patients. The data was gathered from hospital records. The purpose of this study was to highlight significant data related to COVID-19 patients’ infection, symptoms and prognosis with respect to ABO blood type and Rh factor. Results of the current study included links between Rh factor and ABO blood types with increased infection potential, longer incubation times and fatal acute outcomes. Knowing that COVID-19 predisposing factors might help with patient survival, illness treatment and studying viral path physiology. A total of 2480 samples were ،distributed to control group and hospitalized patients with definite COVID-19 infection in isolation in the hospital in Mosul City for the period between 2nd December 2021 and 5th March 2022. The blood samples were obtained from patients and healthy donors by using kit for blood type identification, while the blood types of the deceased were taken from the hospital records. Several statistical tests were also conducted to find out the differences between the aforementioned groups. ANOVA was performed to investigate the correlation of ABO blood types with incidence of COVID-19 patients. The variables adopted in the analysis were age and sex. The study found that the difference between the association of each blood group with that of cases was significantly correlated (p = 0.00001). Out of total 975 patients 30.2% had blood group A, 27.3% had group B, 26.8% had group O and 15.7% had blood group AB. The study found that the number of recovered patients in 18-30 years age group was not significant among male and female population, while number of patients in other age groups in both male and female patients who finally recovered, was significantly lesser among patients with blood groups A and AB. There was a significant number of patients with blood group B in all the age groups except 31-35 years old. The study concluded that blood group B patients were severely affected by COVID-19.

Inappropriate Prescribing of Nirmatrelvir/Ritonavir in Solid Organ Transplantation With COVID-19 Infection: A Multicenter Retrospective Study

BackgroundNirmatrelvir-ritonavir (NR) has demonstrated effectiveness in halting the progression to severe coronavirus disease 2019 (COVID-19) among solid organ transplant recipients (SOTRs) infected with Severe Acute Respiratory Syndrome Coronavirus 2. However, it has a wide range of interactions, especially with immunosuppressants. The study aimed to comprehensively evaluate the Inappropriate prescribing of NR and immunosuppressants in SOTRs with COVID-19, while also highlighting the essential aspects. MethodsWe included hospitalized SOTRs who received NR at five tertiary hospitals between December 2022 and June 2023, and evaluated their prescription. ResultsA total of 211 patients were enrolled, of which 205 did not meet all criteria for appropriate prescribing (97.16%). Inappropriateness primarily stemmed from starting treatment more than 5 days after symptom onset (87.68%), followed by application in severe-to-critical cases of COVID-19 (52.13%), the inappropriate dosages based on renal function (47.87%). Contraindications encompassed 17.06% of patients with severe renal impairment and 5.69% with contraindicated drug interactions. Inappropriate resumption of immunosuppressants accounted for a larger proportion than inappropriate discontinuation or dose adjustment (30.16% vs 8.99%). More than one-third of patients neglected to monitor concentrations. About 8% experienced abnormal high concentrations. ConclusionInappropriate prescribing of NR is widespread among hospitalized SOTRs. Adjusting doses based on patients’ renal function and paying attention to concurrent use of immunosuppressive drugs are crucial, and therapeutic drug monitoring is necessary. Clinical practitioners should enhance their vigilance and attention.

KNOWLEDGE, PERCEPTION, AND STIGMA IN THE JAKARTA COMMUNITY TOWARD TUBERCULOSIS PREVENTION

Introduction: The Corona Virus Infectious Disease (COVID)-19 pandemic has impacted tuberculosis (TB) diagnosis and treatment in Indonesia, making Indonesia rank second in the world’s tuberculosis cases. Tuberculosis epidemiology worsened during the pandemic; an estimated 10.6 million people fell ill with tuberculosis worldwide in 2021, an increase of 4.5% from the previous year (Falzon et al., 2023). Aims: The purpose of this study was to determine the relationship between knowledge, perception, and stigma toward tuberculosis prevention in the community in Jakarta. Methods: Respondents in this study were selected using simple random sampling with the criteria at least 17 years of age and currently not diagnosed as a TB patient. Those who were diagnosed with active TB and were on treatment were excluded from the study. Using a cross-sectional design, this study was analyzed with logistic regression. Results: Two factors were found to be associated with the level of tuberculosis prevention behavior. Respondents with better knowledge about tuberculosis were 5.13 times more likely to make good prevention in tuberculosis (OR=5.129; 95% CI=2.341-11.238; p-value &lt;0.001). In addition, having a positive perception of tuberculosis prevention was also associated with better tuberculosis prevention practices (OR=3.301; 95% CI=1.402-7.772; p-value=0.006). Conclusion: Knowledge and perceptions can also eventually lead to stigma, which results in delayed diagnosis, increases the source of transmission, and hinders efforts to reduce its prevalence. A possible recommendation is to educate the community about TB transmission, treatment, and prevention to dispel myths and negative perceptions.

Clinical, biochemical, and genetic study of TACE/TNF-α/ACE signaling pathway in pediatric COVID-19 infection.

: Pediatric patients infected with coronavirus disease 2019 (COVID-19) have unique clinical characteri-stics. Tumor necrosis factor (TNF) is a proinflammatory cytokine that greatly contributes to tumor pathogenesis. : To describe the presenting characteristics of COVID-19 infection among pediatric patients, and investi-gate the possible role of the TNF-α signaling pathway. : This prospective case-control study included 50 Egyptian pediatric patients with COVID-19 and 50 healthy controls. Clinical, laboratory, and radiological as-sessments were performed. Serum TNF-alpha (TNF-α), TNF-α-converting enzyme (TACE), and angiotensin-con-verting enzyme 2 (ACE2) were measured using enzyme-linked immunosorbent assay. ACE (I/D) (rs4646994), ACE2 rs2285666, and TNF-α-308G/A single nucleotide poly-morphisms (SNPs) were performed using conventional polymerase chain reaction techniques with or without restriction fragment length polymorphism. : The median age was 1 year (interquartile range [IQR], 0.31-2.50 years) in the case group and 1.45 years (IQR, 1.00-3.00) in the control group. The main presenting symptoms were fever (92%), dry cough (74%), and dyspnea (72%). The lymphocytic count was normal in 14 patients (28%), decreased in 16 patients (32%), and in creased in 20 patients (40%) of the case group. Positive chest com-puted tomography finding of COVID-19 infection were demonstrated among 40% of patients using COVID-19 Re-porting and Data System categories (ground-glass op-acity with or without consolidations in the lungs). There were significant increased serum TACE and TNF-α with decreased ACE2 levels among cases versus controls (P< 0.001). The GG genotype and G allele of the TNF-α-308G/A SNP were significantly higher in patients than in controls (P<0.05 for both), with insignificant differences in genotype and allelic frequencies in the ACE (I/D) (rs4646994) and ACE2 rs2285666 SNPs. : The TNF signaling pathway was significantly activated in pediatric COVID-19 infection. Only the TNF-α-308G/A SNP was significantly associated with pediatric COVID-19 infection.

PD-L1 expression and characterization of its carrier macrophages in placentas with acute and specifically post-SARS-CoV-2 infection.

At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, uncertainties about the virus and its dangers during pregnancy caused great uncertainty and fear, especially among pregnant women. New data suggest an increased risk of obstetric complications, including maternal complications, preterm labor, intrauterine growth restriction, hypertensive disorders, stillbirths, gestational diabetes and risk, of neonatal developmental disorders. In addition, preeclampsia (PE)-like syndromes were also induced by severe COVID-19 infection. Therefore, the aim of this study was to investigate the expression of CD68 and CD163 and PD-L1 on placental tissues from acute covid patients, patients who survived a covid-19 infection and normal term controls that are known to be dysregulated in preeclampsia cases.We examined a total of 60 placentas from women that had given birth to female or male offspring in the University Hospital Augsburg. We investigated ten acute COVID-19 females, ten acute COVID-19 males, ten post-COVID-19 females, ten post-COVID-19 males, ten female term controls, and ten male term controls. Immunohistochemical staining against CD68, CD163, and PD-L1 was performed and the expression of the markers was evaluated with an immunoreactive score (percentage score). Identity of CD163- or PD-L1 expressing cells was analyzed by double immune fluorescence analyses. In opposite to PE, CD163 positive maternal macrophages are significantly upregulated in the decidua of male acute COVID-19 placentas. PD-L1 is significantly upregulated on male acute- and post-COVID-19 decidual immune cells and on male post-COVID-19 extravillous trophoblast cells. Surprisingly the observed effects are related to the fetal gender as they were not observed in female offsprings. Further investigation is necessary to analyze especially the imprinting effect of this infection.

Rhabdomyolysis secondary to COVID-19 infection and vaccination: a review of literature.

Rhabdomyolysis (RML), characterized by the breakdown of skeletal muscle fibers and the release of muscle contents into the bloodstream, has emerged as a notable complication associated with Coronavirus disease 2019 (COVID-19) infection and vaccination. Studies have reported an increased incidence of RML in individuals with severe COVID-19 infection. However, the exact mechanisms remain unclear and are believed to involve the host's immune response to the virus. Furthermore, RML has been documented as a rare adverse event following COVID-19 vaccination, particularly with mRNA vaccines. Proposed mechanisms include immune responses triggered by the vaccine and T-cell activation against viral spike proteins. This study aims to review the current literature on the incidence, pathophysiology, clinical presentation, and outcomes of RML secondary to COVID-19 infection and vaccination. We identify common risk factors and mechanisms underlying this condition by analyzing case reports, clinical studies, and pharmacovigilance data. Our findings suggest that while RML is a relatively rare adverse event, it warrants attention due to its potential severity and the widespread prevalence of COVID-19 and its vaccines. This review underscores the need for heightened clinical awareness and further research to optimize management strategies and improve patient outcomes in this context.

The impact of COVID-19 on women's reproductive system.

The coronavirus disease 2019 (COVID-19) pandemic has been a major global focus since 2019. However, drug development and vaccination have been unable to stop the rise in the number of COVID-19 infections. As a result, almost everyone has been infected with COVID-19. As the COVID-19 pandemic nears its end, it is important to explore whether contracting COVID-19 has any irreversible effects on the female reproductive system. This article aims to review the effects of COVID-19 on the female ovary and reproductive system and examine whether these effects are permanent. In conclusion, we can state that COVID-19 has not caused any long-lasting effects on the reproductive health of most women, with the exception of a few cases where premature ovarian failure has been observed. These temporary effects, such as menstrual disturbances and temporary fertility loss, tend to diminish and eventually disappear over time.

The impact of social and environmental factors on triggering multiple sclerosis onset, before and during the COVID-19 pandemic: a retrospective study from Iran

BackgroundMultiple sclerosis (MS) is a chronic, inflammatory, and demyelinating disease of the central nervous system. The first presentation’s possible triggers are still controversial among scientists. The objective of this study is to investigate and compare the potential social, environmental, and physical factors that may have contributed to the onset of MS before and during the Coronavirus Disease 2019 (COVID-19) pandemic.MethodsA questionnaire was designed in the MS research center of Sina Hospital and also distributed as an online Google Form on social media among Iranian MS patients. Demographic information, MS disease-related data, and possible patients reported MS triggers were recorded. They were containing stressful life events, COVID-19 and other infections, COVID-19 and other vaccines, pregnancy or labor, head trauma, surgery, and weight loss. Patients were divided into two groups regarding the time of MS diagnosis (before and during the COVID-19 pandemic).ResultsOf 920 participants, 670 (72.8%) were female, and the mean age ± SD was 35.63 ± 8.1. The majority of patients (69.2%) had non-progressive forms of MS, and only 7.6% needed assistance for ambulation. 69% of participants were diagnosed with MS before the onset of the COVID-19 pandemic. There was a statistically significant difference between the most common first MS symptom before and after the beginning of the pandemic (visual type (n: 317 (49.9%)) before and sensory type (n: 170 (59.6%)) after the COVID-19 pandemic). A stressful life event was the most common patient-reported trigger of MS first presentation in both groups. (56.1% before and 54% after the COVID-19 pandemic). Comparing two groups, economic problems (AOR: 1.81; 95% ACI: 1.23–2.65) and job losses (AOR: 2.89; 95% ACI: 1.37–6.08) were significantly more common triggers for the initial presentation of MS after the pandemic, while the stress of occupational or educational exams (AOR: 0.52; 95% ACI: 0.34–0.79) was more prevalent before the pandemic.ConclusionPatients believe that stressful life events are closely linked to triggering their first MS symptoms. Since the beginning of the COVID-19 pandemic, economic problems and job losses have increased; however, occupational or educational exams stress decreased. Caring for social stress by societies may affect MS development or delay MS onset.

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.

Development of COVID-19 Infection Prevention and Control Training Program Based on ADDIE Model for Clinical Nurses: A Pretest-Posttest Study.

Scientific and effective training is important to enhance the theoretical knowledge and practical skills of clinical nurses in coronavirus disease 2019 (COVID-19) prevention and control (IPC), so as to improve the IPC capacity. The study aimed to design and implement a COVID-19 IPC training program for clinical nurses based on the ADDIE model, and to evaluate its clinical application effects. This was a pretest-posttest study in which 389 clinical nurses were recruited through convenience sampling. The IPC training program for clinical nurses was developed based on the five stages of ADDIE model. Data were analyzed using pared-sample t test, McNemar's test, and Wilcoxon test. After training, nurses' theoretical scores and operational scores except for hand hygiene were improved significantly (p < 0.001). Compared to pre-training assessment, their job performances were also significantly improved (p < 0.001). And they had higher satisfaction with the program post-training. Under the situation of COVID-19, training based on the ADDIE model can effectively improve the IPC ability of clinical nurses. Besides, it provides new ideas, methods, and approaches for future clinical IPC training.

Possible Link between Gut Microbiota, Diet, and COVID-19 Infection

Background: Coronavirus disease 2019 (COVID-19) is a concern for world health since it may impact both the upper (nose, throat, sinuses) and lower (trachea, lungs) respiratory tracts. Death (at a rate of 10%), respiratory failure, multi-organ failure, and acute respiratory distress syndrome (ARDS) are among the problems that might arise. Recent years have seen a global spread of zoonotic coronaviruses, which have caused human epidemics such as MERS and SARS. Various clinical symptoms may be seen in this sickness because to the numerous changes in intestinal homeostasis caused by SARS-CoV-2. Because of the beneficial impact that probiotics have on the host immune system, gastrointestinal disorders may now be effectively treated. This article discusses the close relationship between what we eat, the bacteria in our gut, and the risk of contracting the COV-19 virus. Conclusion: The relationship between gut microbiota, dietary factors, and COVID-19 severity indicates that the microbiome may influence immune regulation. Imbalances in microbial communities and reduced diversity can intensify inflammation, potentially worsening COVID-19 outcomes. Strategies such as probiotics, prebiotics, and dietary changes might provide therapeutic benefits by improving gut health and strengthening immune defenses. However, further research is required to clarify these mechanisms and establish effective interventions.

Brain-wide alterations revealed by spatial transcriptomics and proteomics in COVID-19 infection.

Understanding the pathophysiology of neurological symptoms observed after severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection is essential to optimizing outcomes and therapeutics. To date, small sample sizes and narrow molecular profiling have limited the generalizability of findings. In this study, we profiled multiple cortical and subcortical regions in postmortem brains of patients with coronavirus disease 2019 (COVID-19) and controls with matched pulmonary pathology (total n = 42) using spatial transcriptomics, bulk gene expression and proteomics. We observed a multi-regional antiviral response without direct active SARS-CoV2 infection. We identified dysregulation of mitochondrial and synaptic pathways in deep-layer excitatory neurons and upregulation of neuroinflammation in glia, consistent across both mRNA and protein. Remarkably, these alterations overlapped substantially with changes in age-related neurodegenerative diseases, including Parkinson's disease and Alzheimer's disease. Our work, combining multiple experimental and analytical methods, demonstrates the brain-wide impact of severe acute/subacute COVID-19, involving both cortical and subcortical regions, shedding light on potential therapeutic targets within pathways typically associated with pathological aging and neurodegeneration.