COVID-19 Group Research Articles

Impact of the COVID-19 Pandemic on Self-Confidence in Patient Treatment in the Endodontic and Restorative Procedures of Dentistry Students at the University of Novi Sad.

(1) Background: The COVID-19 pandemic has brought about a change in the concept of teaching with the introduction of online lectures and "distance learning." The aim of this study was to determine the impact of the COVID-19 pandemic on the confidence and both theoretical and practical knowledge of dental students regarding the courses in conservative dentistry and endodontics. (2) Methods: The study was conducted using an originally created online questionnaire consisting of 30 questions that the students used to make a subjective assessment of their confidence in performing both endodontic and conservative procedures using numerical scales. They were divided into two groups, a non-COVID group of students, who attended classes before the outbreak of the pandemic, and a COVID group, whose classes were suspended due to the lockdown. The data were processed in the SPSS statistic 25 program, with statistical significance p < 0.05. (3) Results: The comparison of the self-assessment of 96 students from the COVID group and 91 students from the non-COVID group revealed significant results. Compared with the COVID group, the non-COVID students felt more confident in the application of anesthesia in both the maxilla and mandible, in the initial treatment of patients in pain, as well as in all the steps of the endodontic treatment. Both groups felt equally confident in diagnostic and conservative procedures, and the level of theoretical knowledge acquired in the courses. (4) Conclusions: Changes in teaching due to the COVID-19 pandemic had an unfavorable effect on students' self-confidence in performing routine dental interventions, especially in the endodontic field. The lack of confidence in the COVID group regarding the anesthetic and endodontic procedures appears due to their inability to do any of these procedures during the COVID period; we organized summer practical school under the supervision of teachers, and they gained the necessary knowledge and self-confidence for these procedures.

One-year post-acute COVID-19 syndrome and mortality in South Korea: a nationwide matched cohort study using claims data.

Current understanding of post-COVID-19 syndrome in South Korea is primarily based on survey studies or research targeting specific patient groups, such as those hospitalized. Moreover, the majority of relevant studies have been conducted in European and North American populations, which may limit their applicability to the South Korean context. To address this gap, our study explores the one-year outcomes of COVID-19, focusing on the potential post-acute syndrome and all-cause mortality in South Korea. This retrospective cohort study used nationwide claims data in South Korea, including adults aged >18 with records between January 20, 2020, and February 25, 2021. Patients were classified into COVID-19 and non-COVID-19 groups and matched 1:1 based on propensity scores. Primary outcomes were 12-month post-acute COVID-19 syndrome and all-cause mortality. The study involved 34,802 matched patients. The COVID-19 group had significantly elevated risks of coagulopathies (OR = 2.70 [2.24, 3.28]; p < 0.001), chronic lower respiratory diseases (OR = 1.96 [1.80, 2.14]; p < 0.001), symptoms of the circulatory and respiratory systems (OR = 1.91 [1.80, 2.04]; p < 0.001), mood disorders (OR = 1.67 [1.51, 1.86]; p < 0.001), cardiac diseases (OR = 1.39 [1.21, 1.59]; p < 0.001), and symptoms of cognition, perception, emotional state, and behavior (OR = 1.15 [1.04, 1.27]; p = 0.005). All-cause mortality was higher in the COVID-19 group during the 6 months (OR = 1.34 [1.06, 1.69]; p = 0.015), but gradually decreased, reaching an OR of 0.996 ([0.83, 1.19]; p = 0.964) at 1 year. In South Korea, the 12-month post-acute COVID-19 syndrome includes coagulopathies, respiratory issues, mood disorders, and cardiac diseases. The risk of all-cause mortality post-COVID-19 is heightened for up to 6 months, then significantly decreases and resolves within a year.

P-547 Impact of SARS-COV-2 infection on embryo euploidy rate: a retrospective cohort study of 498 PGT-A cycles in China

Abstract Study question Does SARS-CoV-2 infection before oocyte retrieval have any impacts on embryo euploidy rate? Summary answer SARS-CoV-2 infection before oocyte retrieval had no detrimental impact on embryo euploidy rate, indicating that cycle cancellation due to SARS-CoV-2 infection may not be necessary. What is known already SARS-CoV-2 infection has significant effects on the health of people worldwide and poses a serious threat to reproductive health. According to the previous studies, SARS-CoV-2 infection had negative impacts on the blastocyst formation rate, top-quality embryos rate. However, the association between the infection and the embryo euploidy rate is indeterminate. It is still worth exploring the impact of SARS-CoV-2 infection on embryo euploidy rate. Especially this is the key question to be addressed for providing appropriate counseling to couples seeking for preimplantation genetic testing for aneuploidy (PGT-A) treatments during the ongoing pandemic. Study design, size, duration This was a retrospective cohort study of 498 couples who underwent PGT-A cycles with next-generation sequencing technology from November 1st, 2022 to June 30th, 2023 at a tertiary-care medical center in China. Participants/materials, setting, methods Women tested positive for SARS-CoV-2 before oocyte retrieval were included in the COVID-19 group, while patients who were asymptomatic and tested negative during the same period were included in the non-COVID-19 group. The primary outcome was the euploidy rate. Subgroup analysis was conducted according to the time interval between infection and oocyte retrieval. Univariate and multivariate logistic regression models were applied to adjust for potential confounders. Main results and the role of chance A total of 278 and 220 women were included in the COVID-19 and non-COVID-19 group, respectively. In the COVID-19 group, the maturated oocyte rate (79.5% vs. 83.7%, p＜0.001), number of total viable embryos (2 vs. 3, p=0.038), and number of euploid blastocyst (1 vs. 1, p=0.028) were significantly decreased compared with non-COVID-19 group. The euploidy rate (38.5% vs.40.3%, p = 0.451), aneuploidy rate (45.0% vs. 43.8%, p=0.616), and mosaicism rate (16.5% vs. 15.9%, p=0.746) were all comparable between the two groups. Results of multivariate logistic regressions revealed no association between SARS-CoV-2 infection and euploidy rate, aneuploidy rate, or mosaicism rate. Similarly, no association was detected between the time interval of infection and oocyte retrieval (≤30 days, 31-60days, 61-90 days, 91-120 days, or ≥ 120 days prior to oocyte retrieval) and euploidy rate. Limitations, reasons for caution The retrospective nature of the study and limited sample size for subgroup analysis limits the generalizability of the findings. Other potential confounders, such as the level of SARS-CoV-2 antibody, symptoms of infection, are needed to be taken into consideration as well. Large-scale prospective studies are warranted to confirm the conclusion. Wider implications of the findings Our study demonstrated that SARS-CoV-2 infection before oocyte retrieval had no detrimental impact on embryo euploidy rate, indicating that cycle cancellation due to SARS-CoV-2 infection may not be necessary. Trial registration number Not Applicable

Outcomes of Primary Percutaneous Coronary Intervention in Post COVID-19 Patients Presenting with ST Segment Elevation Myocardial Infarction

Abstract Background Coronavirus disease-2019 (COVID-19) is thought to predispose patients to wide variety of thrombotic disease, including Acute Coronary Syndromes (ACS). While such fact is established in literature to occur during the acute infection, data regarding the long term thrombotic effects of COVID-19 are still unclear. Aim and Objectives To determine the special coronary angiographic findings, the procedural and clinical success of revascularization among post COVID-19 patients presenting with STEMI. Patients and Methods This study was performed on a 100 patients who presented to emergency departments of Ain shams university hospitals with ST Segment Elevation Myocardial Infarction and underwent primary PCI, during a period of 6 months: From January to June of 2022. The patients were randomized into two groups: Group (A) the Post COVID-19 group, comprising 50 patients who developed COVID-19 infection in the past 6 months, as diagnosed at the time by RT-PCR or a CT chest of CORADS-IV or more – and group (B) the Control group, comprising 50 patients who deny COVID-19 infection in the past 6 months, endorsed by a negative COVID-19 antibody test. A subgroup analysis was done where patients in group (A) were further divided into two subgroups: the Early Post-COVID subgroup, having developed STEMI within 8 weeks of infection and comprising 16 patients, and the Late Post-COVID subgroup, having developed STEMI &amp;gt;8-24 weeks post infection and comprising 34 patients. The groups were compared as regards clinical, angiographic, laboratory and echocardiographic outcomes of percutaneous intervention. Results Our study demonstrated that patients who developed STEMI within 8 weeks of a COVID-19 infection (the Early Post-COVID subgroup) showed a statistically significant high thrombus burden on angiography, at 81.3% versus 48% of the control group. A high thrombus burden was defined in our study as having a modified thrombus grade of 4 or more. This subsequently resulted in higher use of pre-dilatation (56.2% versus 24%) and thrombus aspiration (43.8% versus 4%) in the Early Post- COVID subgroup, both at a statistically significant level (P-values = 0.015 and 0.001 respectively). Coronary No-Reflow was a much more frequent complication following PCI in the Early post-COVID subgroup (62.5%) compared to the Control group (22%). These patients also suffered a lower Ejection Fraction on Echocardiography (Mean 36% versus 43.4%) and a larger LVIDs (Mean 47mm versus 43.9mm) as compared to the Control group. This data translated clinically into a higher MACE among the Early Post-COVID patients, at 31.3% versus 6% of the control group. Of note that these differences were not as evident upon comparing the whole post COVID group to the control group. Conclusion We concluded that the thrombogenic effect of COVID-19 on the outcomes of STEMI persists even after resolution of the infection but gradually declines overtime. It affects the angiographic, procedural and overall clinical success of revascularization during in-hospital stay. This effect is maximal during the first 8 weeks after infection, but declines thereafter.

Tissue-based T cell activation and viral RNA persist for up to 2 years after SARS-CoV-2 infection.

The mechanisms of postacute medical conditions and unexplained symptoms after SARS-CoV-2 infection [Long Covid (LC)] are incompletely understood. There is growing evidence that viral persistence, immune dysregulation, and T cell dysfunction may play major roles. We performed whole-body positron emission tomography imaging in a well-characterized cohort of 24 participants at time points ranging from 27 to 910 days after acute SARS-CoV-2 infection using the radiopharmaceutical agent [18F]F-AraG, a selective tracer that allows for anatomical quantitation of activated T lymphocytes. Tracer uptake in the postacute COVID-19 group, which included those with and without continuing symptoms, was higher compared with prepandemic controls in many regions, including the brain stem, spinal cord, bone marrow, nasopharyngeal and hilar lymphoid tissue, cardiopulmonary tissues, and gut wall. T cell activation in the spinal cord and gut wall was associated with the presence of LC symptoms. In addition, tracer uptake in lung tissue was higher in those with persistent pulmonary symptoms specifically. Increased T cell activation in these tissues was also observed in many individuals without LC. Given the high [18F]F-AraG uptake detected in the gut, we obtained colorectal tissue for in situ hybridization of SARS-CoV-2 RNA and immunohistochemical studies in a subset of five participants with LC symptoms. We identified intracellular SARS-CoV-2 single-stranded spike protein-encoding RNA in rectosigmoid lamina propria tissue in all five participants and double-stranded spike protein-encoding RNA in three participants up to 676 days after initial COVID-19, suggesting that tissue viral persistence could be associated with long-term immunologic perturbations.

SARS-CoV-2 Infection during Delivery Causes Histopathological Changes in the Placenta.

SARS-CoV-2 can damage human placentas, leading to pregnancy complications, such as preeclampsia and premature birth. This study investigates the histopathological changes found in COVID-19-affected placentas. This study included 23 placentas from patients with active COVID-19 during delivery and 22 samples from patients without COVID-19 infection in their medical history. The samples underwent histopathological examination for pathology, such as trophoblast necrosis, signs of vessel damage, or fetal vascular malperfusion. Newborns from the research group have lower weights and Apgar scores than healthy newborns. In the COVID-19 group, calcifications and collapsed intervillous space were more frequent, and inflammation was more severe than in the healthy group. At the same time, the placenta of SARS-CoV-2-positive patients showed signs of accelerated vascular maturation. Trophoblast necrosis was found only in the placentas of the research group. The expression of CD68+ was elevated in the COVID-19 cohort, suggesting that macrophages constituted a significant part of the inflammatory infiltrate. The increase in lymphocyte B markers was associated with placental infarctions, while high levels of CD3+, specific for cytotoxic T lymphocytes, correlated with vascular injury. SARS-CoV-2 is associated with pathological changes in the placenta, including trophoblast necrosis, calcification, and accelerated villous maturation. Those changes appear to be driven by T cells and macrophages, whose increased expression reflects ongoing histiocytic intervillositis in the placenta.

Preliminary study: nutrigenomics analysis results of COVID-19 survivors

BackgroundNumerous attempts have been made at both prevention and treatment of COVID-19. Specific genotypes carry a risk of causing clinical symptoms that can be beneficial or detrimental. We performed nutrigenomics testing on COVID-19 survivors who were on ventilators during their treatment and mild COVID-19 survivors who did not require ventilators to determine the risk of genetic variation through nutrigenomic testing regarding COVID-19 incidence. DNA was isolated from saliva and genotyped for genetic markers using a commercially available nutrigenomics test. We compared genotype frequencies between those with severe symptoms (cases) and those with mild symptoms (controls).ResultSequencing results showed that the distribution from pattern of the Sankey diagram included an ultra risk category in the control group, but not in the case group. None of the subjects in the case group were in the ultra risk category for resilience. A descriptive pattern of risk-level distribution was observed in both the control and case groups. One subject in the ultra risk category was in the control group, indicating a lower risk factor for severe COVID-19.ConclusionFrom this study, a uniqueness begins to emerge, revealing the discovery of ultra-category patterns in the endurance of the control group. The vitamin E risk deficiency is significantly higher in the severe COVID-19 group compared to the mild group, categorized as "typical."

Comparison of Changes in the Neutrophil-lymphocyte Ratio (NLR) and Post-surgery Outcomes in Child Patients with COVID-19 and Non-COVID-19

Background Pediatric patients with COVID-19 who undergo surgery have two actual problems, both the presence of a viral inflammatory response and an inflammatory response to surgery, which can affect the outcome of surgery and therapy. NLR is considered a fairly accurate predictor of surgery and COVID-19 infection. Objective This study aims to investigate the effect of changes in neutrophil-lymphocyte (NLR) on post-surgery outcomes in pediatric patients with COVID-19 infection. Methods It is a retrospective cohort study with an observational analysis. This research is a multi-center study on COVID-19 patients using a data bank of pediatric patients with COVID-19 and control patients non COVID-19 children undergoing surgery in three hospitals. Data recorded were age, gender, nutritional status, anesthetic status before surgery, length of stay, repeat surgery, sepsis, septic shock, and mortality. Statistical analysis was performed by the U-mann Whitney test. Results The study sample consisted of 87 total samples consisting of 2 groups, namely the group of pediatric patients with 29 samples with COVID-19 and 58 non-COVID-19 samples. Gender, nutritional status, length of stay, the incidence of reoperation, sepsis, septic shock, and mortality were not significantly different between the two groups with a p&lt;0.05. Risk analysis by looking at the incidence of sepsis and septic shock obtained an intersection point of 2.175 and 2.225, respectively. Analysis of changes in the NLR (delta-NLR) in the mortality events of the COVID-19 group and non-COVID-19 found that the NLR of the COVID-19 group was two times greater than the cut-off NLR of 2,175. Conclusion There is no difference in the outcome of surgery for children with COVID-19 and non-COVID-19 based on the NLR change analysis.

The Characteristics of Coronary Artery Lesions in COVID-19 Infected Patients With Coronary Artery Disease: An Optical Coherence Tomography Study

COVID-19 may predispose patients to cardiac injuries but whether COVID-19 infection affects the morphological features of coronary plaques to potentially influence the outcome of patients with coronary artery disease (CAD) remains unknown. By using optical coherence tomography (OCT), this study compared the characteristics of coronary plaque in patients with CAD with/without COVID-19 infection. The 206 patients were divided into 2 groups. The COVID-19 group had 113 patients between December 7, 2022, and March 31, 2023, who received OCT assessment after China decided to lift the restriction on COVID-19 and had a history of COVID-19 infection. The non-COVID-19 group had 93 patients without COVID-19 infection who underwent OCT before December 7, 2022. The COVID-19 group demonstrated a higher incidence of plaque ruptures (53.1% vs 38.7%, p = 0.039), erosions (28.3% vs 11.8%, p = 0.004), fibrous (96.5% vs 89.2%, p = 0.041) and diffuse lesions (73.5% vs 50.5%, p <0.001) compared with the non-COVID-19 group, whereas non-COVID-19 group exhibited a higher frequency of cholesterol crystals (83.9% vs 70.8%, p = 0.027), deep calcifications (65.6% vs 51.3%, p = 0.039) and solitary lesions (57.0% vs 34.5%, p = 0.001). Kaplan-Meier survival analysis revealed a significantly lower major adverse cardiac events-free probability in the COVID-19 group (91.6% vs 95.5%, p = 0.006) than in the non-COVID-19 group. In conclusion, OCT demonstrated that COVID-19 infection is associated with coronary pathological changes such as more plaque ruptures, erosions, fibrosis, and diffuse lesions. Further, COVID-19 infection is associated with a higher propensity for acute coronary events and a higher risk of major adverse cardiac events in patients with CAD.

The Pathognomonic ultrasonographic findings in fetus with COVID-19 infection

Aim: The main goal is to identify the pathognomonic sonographic signs for foetal SARS-CoV-2 infection and to determine whether or not transplacental SARS-CoV-2 transmission is possible. Patients and Methods: In total, 105 pregnant women with positive SARS-CoV-2 PCR swabs during the first trimester with mild or moderate infection without hospitalisation and/or oxygen support were included in this prospective comparative study, which was carried out at the ultrasound and foetal medicine unit of Ain Shams University Maternity Hospital from January 2021 to June 2023. The SARS-CoV-2 positive group was compared to the control group with inclusion and exclusion criteria. Results: In the COVID-19 group, pathognomonic ultrasonographic results were considerably more common. The COVID-19 group had a considerably higher frequency of placental calcifications and oligohydramnios. In the COVID-19 cohort, patients with positive pathognomonic ultrasonographic results had considerably higher BMIs. In the COVID-19 cohort, gestational age at infection, and BMI ≥30.0 kg/m2 were significant independent risk factors for the development of pathognomonic ultrasonographic abnormalities. Those in the control group who had positive pathognomonic ultrasonographic results were older and had higher rates of hypertension. Significant independent risk variables for the incidence of pathognomonic ultrasonographic findings in the control group included age ≥34.0 years and hypertension. Conclusion: There is no evidence of a teratogenic effect linked to maternal SARS-CoV-2 infection during the first few months of pregnancy. However, early pregnancy infection with COVID-19 is linked to pathognomonic ultrasonography findings of placental calcifications and oligohydramnios.

Risk of pulmonary embolism and deep vein thrombosis following COVID-19: a nationwide cohort study.

Recent studies elucidate that coronavirus disease 2019 (COVID-19) patients may face a higher risk of cardiovascular complications. This study aimed to evaluate association of COVID-19 with the risk of pulmonary embolism (PE) or deep vein thrombosis (DVT). This nationwide population-based retrospective cohort study included Korean adult citizens between January 2021 and March 2022 from the Korea Disease Control and Prevention Agency COVID-19 National Health Insurance Service cohort. The Fine and Gray's regression with all-cause death as a competing event was adopted to evaluate PE and DVT risks after COVID-19. This study included a total of 1,601,835 COVID-19 patients and 14,011,285 matched individuals without COVID-19. The risk of PE (adjusted hazard ratio [aHR], 6.25; 95% confidence interval [CI], 3.67-10.66; p<0.001) and DVT (aHR, 3.05; 95% CI, 1.75-5.29; p<0.001) was higher in COVID-19 group in individuals without complete COVID-19 vaccination. In addition, individuals with complete COVID-19 vaccination still had a higher risk of COVID-19-related PE (aHR, 1.48; 95% CI, 1.15-1.88; p<0.001). However, COVID-19 was not a significant risk factor for DVT among those with complete COVID-19 vaccination. COVID-19 was identified as an independent factor that elevated PE and DVT risks, especially for individuals without complete COVID-19 vaccination.

Impact of COVID-19 on brain connectivity and rehabilitation outcome after stroke

BackgroundCoronavirus disease (COVID-19) may induce neurological issues, impacting brain structure and stroke recovery. Limited studies have explored its effects on post-stroke rehabilitation. Our study compares brain structure and connectivity, assessing rehabilitation outcomes based on pre-stroke COVID-19 infection. MethodsA retrospective analysis of 299 post-stroke rehabilitation cases from May 2021 to January 2023 included two groups: those diagnosed with COVID-19 at least two weeks before stroke onset (COVID group) and those without (control group). Criteria involved first unilateral supratentorial stroke, <3 months post-onset, initial MR imaging, and pre- and post-rehabilitation clinical assessments. Propensity score matching ensured age, sex, and initial clinical assessment similarities. Using lesion mapping, tract-based statistical analysis, and group-independent component analysis MRI scans were assessed for structural and functional differences. ResultsAfter propensity score matching, 12 patients were included in each group. Patient demographics showed no significant differences. Analyses of MR imaging revealed no significant differences between COVID and control groups. Post-rehabilitation clinical assessments improved notably in both groups, however the intergroup analysis showed no significant difference. ConclusionsPrevious COVID-19 infection did not affect brain structure or connectivity nor outcomes after rehabilitation.

The influence of prior COVID-19 diagnosis on concussion recovery outcomes.

While the clinical presentations of COVID-19 and concussion are not identical, there is a significant overlap in symptomology (e.g., fatigue, headache) and neurological deficits (e.g., cognitive, vestibular). However, limited research has examined the effect of prior COVID-19 diagnosis on concussion outcomes. Therefore, the purpose of this study was to determine if prior diagnosis of COVID-19 influences concussion outcomes, including concussion assessment scores and recovery time, in college-aged individuals. A prospective study of college-aged individuals (COVID-19: n = 43, mean age 21.3 [SD 2.5] years; no COVID-19: n = 51, mean age 21.0 [SD 2.5] years) diagnosed with concussion was conducted. Demographics, injury details, the Sport Concussion Assessment Tool 5th Edition (SCAT5), and the Vestibular/Ocular Motor Screening (VOMS) were completed at the acute (within 5 days after concussion) and full medical clearance (FMC) (within 3 days after FMC) visits. Mann-Whitney U-tests determined differences in concussion outcomes between groups. Cox proportional hazards regression models were fitted to assess the relationship between factors associated with concussion symptom resolution and days to FMC, and covariates were selected based on previous literature indicating potential confounds (e.g., female sex, acute symptom severity, preexisting mental health conditions). Hazard ratios with 95% confidence intervals were reported for each predictor variable. No significant differences were found between groups for SCAT5 and VOMS composite and total scores. Significant differences were found between COVID-19 and no-COVID-19 groups in days to symptom resolution (11.5 days vs 8 days, p = 0.021), but not in days to FMC (14 days vs 12 days, p = 0.099). The association between COVID-19 groups and days to clearance was not significant when adjusting for sex, race, history of depression/anxiety, and total number of concussion symptoms at the acute visit [χ2(5) = 8.349, p = 0.138]. However, male sex (HR 2.036, 95% CI 1.033-4.014; p = 0.040) was associated with a quicker time to FMC. Prior COVID-19 diagnosis did not influence cognitive abilities and vestibular/ocular functioning as measured by the SCAT5 and VOMS postconcussion. While prior COVID-19 diagnosis did result in a significantly longer duration to symptom resolution when compared with individuals who did not have a prior COVID-19 diagnosis, prior COVID-19 did not significantly influence time to FMC by a healthcare provider. Clinicians should consider that individuals with a prior diagnosis of COVID-19 might experience prolonged symptoms postconcussion.

Post-COVID Conditions in US Primary Care: A PRIME Registry Comparison of Patients With COVID-19, Influenza-Like Illness, and Wellness Visits.

COVID-19 is a condition that can lead to other chronic conditions. These conditions are frequently diagnosed in the primary care setting. We used a novel primary care registry to quantify the burden of post-COVID conditions among adult patients with a COVID-19 diagnosis across the United States. We used the American Family Cohort, a national primary care registry, to identify study patients. After propensity score matching, we assessed the prevalence of 17 condition categories individually and cumulatively, comparing patients having COVID-19 in 2020-2021 with (1) historical control patients having influenza-like illness in 2018 and (2) contemporaneous control patients seen for wellness or preventive visits in 2020-2021. We identified 28,215 patients with a COVID-19 diagnosis and 235,953 historical control patients with influenza-like illness. The COVID-19 group had higher prevalences of breathing difficulties (4.2% vs 1.9%), type 2 diabetes (12.0% vs 10.2%), fatigue (3.9% vs 2.2%), and sleep disturbances (3.5% vs 2.4%). There were no differences, however, in the postdiagnosis monthly trend in cumulative morbidity between the COVID-19 patients (trend = 0.026; 95% CI, 0.025-0.027) and the patients with influenza-like illness (trend = 0.026; 95% CI, 0.023-0.027). Relative to contemporaneous wellness control patients, COVID-19 patients had higher prevalences of breathing difficulties and type 2 diabetes. Our findings show a moderate burden of post-COVID conditions in primary care, including breathing difficulties, fatigue, and sleep disturbances. Based on clinical registry data, the prevalence of post-COVID conditions in primary care practices is lower than that reported in subspecialty and hospital settings.

Comparison Between Early and Late Tracheostomy in ICU Patients Including COVID-19 and Non-COVID-19 Patients: A Retrospective Cohort Study at a Tertiary Care Hospital.

Background Tracheostomy is a common intervention for intensive care unit (ICU) patients for various reasons. The superiority of early versus late tracheostomy is still unfounded for non-COVID-19 cases. The COVID-19 pandemic complicated the matter, as little literature was available on the ideal timing of tracheostomy for patients with COVID-19. Research question This study aimed to establish the superiority of early or late tracheostomy for COVID-19 and non-COVID-19 cases by comparing outcomes, including ICU mortality, ventilation days after tracheostomy, and ICU length of stay (LOS). Study design and methods A single-center retrospective cohort study was conducted on ventilated ICU patients both with and without COVID-19 at a university hospital between January 2020 and December 2021. During the study period, 1,393 ventilated patients were scanned, and 156 were found to be tracheostomized. Tracheostomy was considered to be early when performed within 10 days of intubation, after which it was considered to be late. Results Tracheostomy was performed early for 84/156 (53.8%) of tracheostomized patients and late for 72/156 (46.2%) of patients. The overall mortality was 42.9% (36/84) versus 69.4% (50/72) (P=0.001, OR=3.03, 95% CI=1.563-5.874), 31.4% versus 65.5% in the non-COVID-19 group and 60.6% versus 72.1% (P=0.005, OR=2.640, 95% CI=1.345-5.181) in the COVID-19 group for the early and late tracheostomy groups, respectively. Ventilation days were higher for the late tracheostomy group than for the early tracheostomy group in the non-COVID-19 group (17.10 versus 9.18 days, P<0.001). However, it was almost the same for the early and late tracheostomy groups in the COVID-19 group (14.15 versus 13.86 days,P=0.821). The ICU LOS was greater for the late tracheostomy group for both the COVID-19 and non-COVID-19 groups. Multivariate analysis revealed that ICU mortality is significantly associated with age, ventilation days, and ICU LOS. Interpretation The results of this study indicate that early tracheostomy was associated with lower mortality, fewer ventilation days, and shorter LOS in both the COVID-19 and non-COVID-19 groups.

КОРОНАВИРУСНАЯ ИНФЕКЦИЯ COVID-19 У ПАЦИЕНТОВ ПОСЛЕ ТРАНСПЛАНТАЦИИ ГЕМОПОЭТИЧЕСКИХ СТВОЛОВЫХ КЛЕТОК: ОБЗОР ЛИТЕРАТУРЫ И СОБСТВЕННЫЙ ОПЫТ

The presented literature review presents studies, including our own, on the peculiarities of the course of coronavirus infection in patients after hematopoietic stem cell transplantation (HSCT). It has been shown that patients after HSCT represent an increased risk group for severe COVID-19 and adverse outcomes. The factors that worsen the prognosis of life of patients after HSCT were old age, male gender, uncontrolled/active disease, concomitant diseases, acute course of SARS-CoV-2 COVID19. It is necessary to carry out monitoring, early diagnosis (regular and timely testing for the virus) and the use of effective prevention and treatment protocols in patients after HSCT in a pandemic. Early diagnosis of infection can prevent the spread of the virus, start treatment quickly and take measures to isolate the patient. In the early period after HSCT, patients are at higher risk of developing lower respiratory tract infection, more often need the appointment of antifungal drugs, antibacterial drugs of reserve groups and have greater risks of death from COVID-19. Therapy with genetically engineered biological drugs is not contraindicated in the case of leukopenia and agranulocytosis in this group of patients. As a result of the analysis, there were no differences in the survival rates of patients after autologous and allogeneic HSCT.

Unmasking vaccine hesitancy and refusal: a deep dive into Anti-vaxxer perspectives on COVID-19 in Spain

BackgroundAt the time of the emergence of COVID-19, denialist and anti-vaccine groups have also emerged and are shaking public confidence in vaccination.MethodsA qualitative study was conducted using online focus groups. Participants had not received any doses of vaccination against the disease. A total of five focus group sessions were conducted with 28 participants. They were recruited by snowball sampling and by convenience sampling.ResultsThe two major topics mentioned by the participants were adverse effects and information. The adverse effects described were severe and included sudden death. In the case of information, participants reported: (1) consultation of websites on which scientists posted anti-vaccination content; and (2) distrust.ConclusionsAt a time when anti-vaccine groups pose a major challenge to public health in general, and to COVID-19 vaccination campaigns in particular, this study is a first step towards gaining deeper insight into the factors that lead to COVID-19 vaccine refusal.

Necrotizing fasciitis of the head and neck in era of COVID-19: a single-institution experience

ObjectivesNecrotizing fasciitis (NF) of the head and neck is a critical condition, known for its severe impact and high mortality rates, often linked with diabetes, odontogenic infections, and immunosuppression. Observations from the University of Ottawa's Department of Otolaryngology – Head and Neck Surgery indicate an increase in NF cases since the COVID-19 pandemic began, suggesting a possible association between COVID-19 and NF. This study aims to assess the incidence of NF since the pandemic's onset and explore its association with COVID-19. DesignConducted as a single-center retrospective review from January 1, 2015 to April 7, 2023, this study included patients aged over 18 years with histopathologic confirmation of NF, analyzing clinical risk factors, treatment, and outcomes. Patients were divided into pre- and post–COVID-19 groups for comparison. ResultsOf 16 patients, 68.7% were in the post–COVID-19 group, with a notable increase in 2022. The most common risk factors were diabetes mellitus (43.8%) and history of odontogenic infection or extraction (31.3%). Only one patient (6.3%) presented with concomitant COVID-19 infection and NF. All patients underwent treatment with serial surgical debridement and intravenous antibiotics with mortality rates rising to 12.5% after the pandemic. ConclusionsOur study demonstrates an increased incidence of NF cases in our institution after the COVID-19 pandemic.

Clinical Characteristics and Maternal and Neonatal Outcomes of Pregnant Women Positive, Negative, and Recovered With COVID-19 Pneumonia

Background: The pandemic of coronavirus disease 2019 (COVID-19) has caused serious concerns about its potential adverse effects on pregnancy. There are limited data on maternal and neonatal outcomes of pregnant Hispanic women with COVID-19. Methods: This study was a retrospective chart review. This cohort included pregnant females between the ages of 18-60 who had tested positive for COVID-19 and tested negative for COVID-19 from the electronic medical records of Texas Tech Health Sciences Department of OB/GYN clinics, University Medical Center (UMC), and El Paso Children’s Hospital (EPCH) from March 2020 to June 2021, in addition to their neonates. Records were analyzed to collect information on demographics, BMI, gestational age, COVID status at the time of delivery, history of exposure to COVID, signs and symptoms of COVID, presenting symptoms, comorbidities, and treatment of COVID before and after delivery. Further, mode of delivery, pregnancy complications, complications during labor, and adverse outcomes (maternal death, admission to ICU, length of stay in ICU). We also collected diagnostic data. The control group included age-matched pregnant individuals without a diagnosis of COVID. The control group was evaluated for the same variables and outcome assessment. For the neonatal outcomes, the mothers were matched to the neonate. Data collected on neonatal outcomes included demographics, date of delivery, APGAR score, admission to the newborn nursery or NICU, the reason for NICU admission, birthweight, length, head circumference, fetal abnormalities, prematurity, neonatal death, COVID test results, breastfeeding (expressed or direct), and length of hospital stay. We also collected diagnostic data for neonates. Statistical analyses was performed using descriptive statistics for the various variables, a t-test to determine differences between the two groups for the continuous variables, and a chi-square test for the categorical variables. Results: During the period March 21, 2020 - June 15, 2021, 370 pregnant women, out of which 100 women were COVID-positive, 71 women who were recovered, and 188 controls. COVID-positive women had more elevated fibrinogen, WBC, alkaline phosphatase, aspartate aminotransferase, and alanine transaminase but nonsignificant CRP levels. Most of the COVID-positive and COVID recovered women had preeclampsia during pregnancy, 29.24% COVID positive women delivered via C-section, while 68.42% of women delivered vaginally. The mean length of stay was 2.97 days for both groups. There 79.41% of women chose to breastfeed. One maternal death was recorded, while only two women had ICU admissions. Compared to the COVID-positive, the recovered women still had significantly elevated fibrinogen but not ALP, ALT, AST, and CRP. The COVID recovered women had lower counts of vaginal delivery (56.3%) and higher C-section rates (39.4%) among the three groups. The recovered group had higher premature deliveries (18%) than the other two groups (8%, 17%). Among the neonatal outcomes, there were four neonatal deaths in the COVID group, two neonates had COVID transmission during delivery, and 19.4 % of neonates were admitted to the NICU. Among neonatal vitals, blood pressure was higher in the positive (41%) and recovered (32.39%) groups than in controls (27.6%). Neonatal hypoglycemia was also higher in the recovered group (27.5%) than in the positive (17.11%) and control group (18.4%). Conclusions: Severe maternal and neonatal complications were not observed in pregnant women with COVID-19 pneumonia who had a vaginal or cesarean delivery. There were complications observed in women who recovered from COVID during pregnancy.

Dynamics of Changes in the Level of Cognitive Functioning Among Patients After SARS-CoV-2 Infection ‒ A Proposal for Remote Neuropsychological Assessment in a Longitudinal Study

Study purpose: The aim of this longitudinal study was to assess the cognitive functioning of people who had COVID-19, to determine the dynamics of changes observed in this area over a period of 3‒4 months, to compare the patients' results with those of a control group, and to verify the usefulness of a new method of remote neuropsychological assessment. Method: A longitudinal study was conducted using the Brief Test of Adult Cognition by Telephone (BTACT) neuropsychological assessment tool, which was translated into Polish for the purpose of the study. The study included subjects following SARS-CoV-2 infection (COVID(+) group) and control subjects (COVID(‒) group). Cognitive functions in both groups were assessed twice, 3‒4 months apart. The study was conducted from July 2020 to January 2022. Results: Data comparisons were performed using mixed ANOVA with repeated measures. Compared to the COVID(‒) group, the COVID(+) group scored significantly lower on the first and second measurements of the Backward Digit Span Test and on the first measurement of the Number Series Test. Additionally, an improvement was observed in COVID(+) group scores in the second measurement compared to the first measurement in: Rey Auditory-Verbal Learning Test (RAVLT) in both the immediate and delayed recall condition; the Backward Digit Span Test, the Number Series Test and 30 Seconds and Counting Task (30-SACT). Conclusions: The obtained results show an impairment in working memory functions and inductive reasoning in COVID(+) subjects compared to COVID(‒) subjects. In addition, the study indicates the usefulness of BTACT in tracking the changes in cognitive functioning over time in individuals following SARS-CoV-2 infection. Tests to assess working memory (Rey Auditory-Verbal Learning Test (RAVLT), Backward Digit Span Test) and a test of inductive reasoning (Number Series Test) appear to be particularly useful in monitoring the mentioned changes.