COVID-19 Positive Patients Research Articles

Seminal Extracellular Traps in SARS-CoV-2 Infection

Introduction: Extracellular Traps (ETs) are fibers composed of chromatin and cytoplasmic proteins, which can trap and kill pathogens by the phenomenon called ETosis. They are released by neutrophils, macrophages, and monocytes, and can be found in semen. The aim of this presentation is to evidence of the indirect effect of SARS-CoV-2 in semen by ETs. Patients and methods: Experimental design: retrospective descriptive observational study. Semen samples from two groups were studied following WHO guidelines: 1) SARS-CoV-2 infected donors (n: 5; at 7, 15, 30, 60, and 90 days after PCR diagnosis); 2) COVID-19 positive patients assisted in our laboratory between 2021 and 2022 (n: 70). They were observed in fresh and in Papanicolaou-stained smears by CASA and light microscopy; the presence of macrophages, spermiophages, ETs and hyperviscosity were recorded while neutrophilic concentration was calculated. Two control groups were designed: a) Patients belonging to group 2, studied before de pandemia (n: 13); b) Culture-negative semen samples (n: 28). Results: In the first group, ETs were observed in all the samples, while only 18% had leucospermia. Macrophages, spermiophages, and hyperviscosity were recorded in 68%, 27%, and 36% of the studied cases respectively. In the second group, ETs were present 100% in the acute phase (< 90 days after diagnosis) and decreased to 71% in the later stage (90 to 270 days). The trapped sperm were non-progressive motile or immotile alive or dead. No traps were found in either control group. Conclusion: In our study ETs were the most sensitive seminal marker of SARS-CoV-2 infection.

Admission blood tests predicting survival of SARS-CoV-2 infected patients: a practical implementation of graph convolution network in imbalance dataset

BackgroundPredicting an individual’s risk of death from COVID-19 is essential for planning and optimising resources. However, since the real-world mortality rate is relatively low, particularly in places like Hong Kong, this makes building an accurate prediction model difficult due to the imbalanced nature of the dataset. This study introduces an innovative application of graph convolutional networks (GCNs) to predict COVID-19 patient survival using a highly imbalanced dataset. Unlike traditional models, GCNs leverage structural relationships within the data, enhancing predictive accuracy and robustness. By integrating demographic and laboratory data into a GCN framework, our approach addresses class imbalance and demonstrates significant improvements in prediction accuracy.MethodsThe cohort included all consecutive positive COVID-19 patients fulfilling study criteria admitted to 42 public hospitals in Hong Kong between January 23 and December 31, 2020 (n = 7,606). We proposed the population-based graph convolutional neural network (GCN) model which took blood test results, age and sex as inputs to predict the survival outcomes. Furthermore, we compared our proposed model to the Cox Proportional Hazard (CPH) model, conventional machine learning models, and oversampling machine learning models. Additionally, a subgroup analysis was performed on the test set in order to acquire a deeper understanding of the relationship between each patient node and its neighbours, revealing possible underlying causes of the inaccurate predictions.ResultsThe GCN model was the top-performing model, with an AUC of 0.944, considerably outperforming all other models (p < 0.05), including the oversampled CPH model (0.708), linear regression (0.877), Linear Discriminant Analysis (0.860), K-nearest neighbours (0.834), Gaussian predictor (0.745) and support vector machine (0.847). With Kaplan-Meier estimates, the GCN model demonstrated good discriminability between low- and high-risk individuals (p < 0.0001). Based on subanalysis using the weighted-in score, although the GCN model was able to discriminate well between different predicted groups, the separation was inadequate between false negative (FN) and true negative (TN) groups.ConclusionThe GCN model considerably outperformed all other machine learning methods and baseline CPH models. Thus, when applied to this imbalanced COVID survival dataset, adopting a population graph representation may be an approach to achieving good prediction.

Coronavirus Fear and Life Quality Perceptions of COVID-19 Positive Patients' Spouses

This study was conducted to determine the fear of coronavirus and quality of life perceptions of the spouses of patients diagnosed with COVID-19 who were treated and discharged. This cross sectional descriptive study was conducted with the spouses of 111 patients who were diagnosed with COVID-19 in a district state hospital and were treated and discharged. Data were collected with the Patient Spouse Identification Form, the COVID-19 Fear Scale, and the WHOQOL BREF 27 Quality of Life Scale. Data were evaluated by percentage, arithmetic mean, standard deviation, t test, Mann Whitney-U test, Kruskal-Wallis test and Pearson Correlation coefficient. The mean COVID-19 Fear scale score of the participants was 16.92 ± 6.20. A statistically significant difference was found between the education level, chronic disease status, hospitalization period of the spouse, and knowledge of the new type of coronavirus and the quality of life sub-dimensions mean scores of the participants. As individuals' fear levels increase, the quality of life psychological health sub-dimension score decreases.

Role of mechanical thrombectomy among large vessel stroke patients during the coronavirus disease (COVID-19) pandemic

PurposeThe aim of our study is to provide insights derived from experience at multiple centers regarding the outcomes of mechanical thrombectomy (MT) for large vessel occlusion (LVO) in COVID-19 patients and compare them with those in non-COVID-19 patients during the coronavirus disease (COVID-19) pandemic.ResultsCOVID‐19 positive patients were younger than COVID‐19 negative patients (62.1 ± 2.69 versus 69.5 ± 2.2, P < 0.001). There was a significant difference between COVID-19 and non-COVID-19 groups in the median D-dimer levels (6 vs. 4.5; P < 0.001), median ESR levels (63 vs. 38; P < 0.001) and median CRP levels (110 vs. 48.5; P < 0.001), respectively. Median time from stroke symptoms onset to hospital admission was significantly higher among COVID-19 positive patients (366 vs. 155 min; P < 0.001). COVID‐19 positive patients with LVO presented with a higher median NIH Stroke Scale score at presentation (16 versus 8, P < 0.001) and lower median Alberta Stroke Program Early CT Score (ASPECTS) on admission (6 versus 8, P < 0.001). Patients with COVID-19 had significantly higher percentages of poor functional outcomes as scored using the mRS grades 3–5 in comparison to non-COVID-19 patients (69.2% vs. 13.6%; P = 0.002), but there was no significant difference between both groups in complications such as early cerebral re-occlusion, intracerebral hemorrhage, or in-hospital mortality (P > 0.05).ConclusionMechanical thrombectomy has effectively managed patients with LVO stroke. LVO stroke in COVID-19 patients occur at a young age, and have multi-territory vascular involvement. Poor functional outcomes post thrombectomy in COVID-19 patients, irrespective of timely, successful angiographic recanalization.

Pediatric COVID-19 diagnosis: The utility of hematological and inflammatory indices

This study aims to systematically assess the diagnostic utility of specific hematological parameters and indices in pediatric patients for the early and accurate diagnosis of COVID-19, thereby contributing to enhanced clinical management and diagnosis of children. The study evaluated the diagnostic potential of hematological and inflammatory markers in 90 pediatric patients, including 49 with COVID-19 and 41 without. It focused on complete blood counts, systemic immune-inflammatory index (SII, calculated as platelet count multiplied by neutrophil count divided by lymphocyte count), platelet to mean platelet volume ratio (PLT/MPV), neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, C-reactive protein, and procalcitonin, comparing these markers between patients with and without COVID-19. COVID-19 positive patients exhibited higher hemoglobin levels and immature granulocyte percentages, along with lower total leukocyte, neutrophil, platelet counts, and procalcitonin levels (p-values: 0.02, 0.006, 0.01, 0.002, 0.007, and 0.01, respectively). The SII and PLT/MPV ratio were significantly lower in the COVID-19 positive group (p=0.01 and p=0.006, respectively), suggesting their potential diagnostic relevance. Receiver Operating Characteristic (ROC) analysis revealed that procalcitonin, PLT/MPV, and SII had comparable diagnostic utility, with area under the curve (AUC) values indicating moderate diagnostic accuracy (procalcitonin AUC: 0.65, p=0.013; PLT/MPV AUC: 0.67, p=0.004; SII AUC: 0.65, p=0.01). Our research highlights the PLT/MPV ratio and SII as breakthrough markers for early detection of COVID-19 in children, providing a significant advance in pediatric diagnostics and enhancing our ability to meet the challenges of the pandemic.

Pediatric Gastrointestinal Outcomes During the Post-Acute Phase of COVID-19: Findings from RECOVER Initiative from 29 Hospitals in the US.

The profile of gastrointestinal (GI) outcomes that may affect children in post-acute and chronic phases of COVID-19 remains unclear. To investigate the risks of GI symptoms and disorders during the post-acute phase (28 days to 179 days after SARS-CoV-2 infection) and the chronic phase (180 days to 729 days after SARS-CoV-2 infection) in the pediatric population. We used a retrospective cohort design from March 2020 to Sept 2023. twenty-nine healthcare institutions. A total of 413,455 patients aged not above 18 with SARS-CoV-2 infection and 1,163,478 patients without SARS-CoV-2 infection. Documented SARS-CoV-2 infection, including positive polymerase chain reaction (PCR), serology, or antigen tests for SARS-CoV-2, or diagnoses of COVID-19 and COVID-related conditions. Prespecified GI symptoms and disorders during two intervals: post-acute phase and chronic phase following the documented SARS-CoV-2 infection. The adjusted risk ratio (aRR) was determined using a stratified Poisson regression model, with strata computed based on the propensity score. Our cohort comprised 1,576,933 patients, with females representing 48.0% of the sample. The analysis revealed that children with SARS-CoV-2 infection had an increased risk of developing at least one GI symptom or disorder in both the post-acute (8.64% vs. 6.85%; aRR 1.25, 95% CI 1.24-1.27) and chronic phases (12.60% vs. 9.47%; aRR 1.28, 95% CI 1.26-1.30) compared to uninfected peers. Specifically, the risk of abdominal pain was higher in COVID-19 positive patients during the post-acute phase (2.54% vs. 2.06%; aRR 1.14, 95% CI 1.11-1.17) and chronic phase (4.57% vs. 3.40%; aRR 1.24, 95% CI 1.22-1.27). In the post-acute phase or chronic phase of COVID-19, the risk of GI symptoms and disorders was increased for COVID-positive patients in the pediatric population.

Retrospective Observational Analysis of Tocilizumab Outcomes in COVID-19 Patients at a Tertiary Care Hospital

Background: Tocilizumab (TCZ), a monoclonal antibody against interleukin-6 (IL-6), was recommended for treatment of Covid-19 patients with a risk of cytokine storm but showed variable effect on outcome. The aim was to assess the association of outcome following tocilizumab administration with various physiological, pathological and pharmacological factor in Covid- 19 patients Methods: Retrospective observational study from June 2020 to July 2020. All indoor Covid positive patients who received tocilizumab were included and relevant information was captured in the case record form. Data was analyzed to the study association of various physiological factors, comorbidities, severity of disease, laboratory parameters and co-administered drugs with the outcome following tocilizumab administration. Results: Total 25 patients received tocilizumab during study period. Older age group (p=0.001), high NEWS score, hypertension (OR: 3.62; p=0.05) and hydroxychloroquine(HCQ) administration (OP=6.66; p=0.009) showed significant association with a worst outcome. Hypertension and hydroxychloroquine usage was analyzed after adjustment with NEWS score using MH adjusted analysis, which revealed a trend of worst outcome in HCQ recipients but the association was not significant with hypertension. High pre-treatment IL-6 (death 570.11+498.76; discharge110.31+ 49.68; p: 0.0011); high post-treatment ferritin level (death 1756.5+ 1622.03; discharge 711.71+ 421.23; p: 0.019) as well as post-tocilizumab rise in ferritin level was associated with worst outcome (p= 0.029). Conclusion: Participants having higher cytokine level/or high NEWS score were unlikely to benefit from tocilizumab. Increased in ferritin level even after tocilizumab appeared to be an indicator of failure of treatment.

Clinico-social Profile and Outcomes of COVID-19 Positive ANC Patients Admitted to Tertiary Care Hospital in Western Maharashtra

Clinico-social Profile and Outcomes of COVID-19 Positive ANC Patients Admitted to Tertiary Care Hospital in Western Maharashtra

COVID-19 in Egyptian Children on Regular Hemodialysis: Experience of a Single Center

Abstract Background COVID-19 is clinically characterized by high rates of transmission, and pathological abnormalities. Pediatric patients with CKD are at high risk of COVID-19 infection &amp; morbidity. Aim of the Work We aimed at studying the rate of infection by COVID-19 in pediatric patients following up at our Pediatric dialysis &amp; Nephrology unit, Ain Shams University. Patients and Methods This retrospective study was conducted over 12 months from 1st of March 2020 to end of February 2021 on 70 pediatric patients with chronic kidney disease stage 5 on regular hemodialysis (CDK5d). Results The mean age &amp; dialysis duration of our studied patients was 11.89 (±3.01) years &amp; 2.17(±1.2)years respectively, where the incidence of COVID-19 infection confirmed by PCR on nasal swab sampleswas 7%. The younger patients had a higher rate of COVID-19 infection than older ones (p = 0.05). Using public transportation during past 14 days before getting COVID-19 infection was significant in COVID-19 positive patients (p = 0.01). The common associated symptoms in our patients were fever, joint ache, muscle ache, loss of appetite, headache, shortness of breath, fatigue, cough, sore throat, nausea, loss of smell or taste, diarrhea, vomiting. Conclusion COVID-19 infection among our CDK5d patients was not uncommon with incidence of 7%, where younger patients were infected more frequently than older patients The common associated symptoms in our patients were fever, joint ache, muscle ache, loss of appetite, headache, shortness of breath, fatigue, cough, sore throat, nausea, loss of smell or taste, diarrhea, vomiting.

Prognostic Value of Neurological Manifestations Related to COVID-19 Positive Patients: Observational Cross-Sectional Study

Abstract Background COVID-19 is an infectious disease caused by severe acute respiratory syndrome coronavirus. Corona virus affects the central nervous system in various different ways either through a retrograde transfer via the olfactory epithelium or through the cribriform bone and reaches the brain directly in seven days’ time or due to disruption of blood brain barrier which occurs during the viremia phase of illness and the virus will enter the brain directly. Another postulated mechanism is the invasion of peripheral nerve terminals by COVID-19 which then gains entry to the CNS through the synapse connected route. Objective To determine the prevalence of neurological symptoms and complications in COVID-19 patients and if we can use the neurological symptoms and its relevance as prognostic factors for disease severity. Patients and Methods This was a cross sectional study that was conducted on COVID-19 positive patients admitted to isolation ICU Ain Shams University Hospital through 4 months. Results The present study aimed to provide a comprehensive overview of neurologic manifestations associated with SARS-CoV-2 infection and to describe the clinical course and outcomes of COVID-19 patients with neurologic manifestations. Our results highlight the broad spectrum of neurological manifestations associated with SARS-CoV- 2 infection: the majority of neurologic manifestations were altered mental status (27.7%), anosmia (13.8%) followed by headache (12.5%). Conclusion the neurological manifestations are common in Covid-19 patients. There is an association between the presence of neurological manifestations and mortality.

Adherence of Mild and Asymptomatic Covid-19 Positive Patients to Ain Shams University Home Isolation Protocol

Abstract Background Egypt has reported almost 515,103 confirmed cases of coronavirus disease (COVID-19) with 24,779 deaths from January 3rd, 2020 to May 29th, 2022. To date, the clinical picture of coronavirus infection among Egyptian patients has not been well-characterized. Asymptomatic infection and mild cases make up a large proportion of infections all over the world. According to Ain Shams University guidelines, asymptomatic and mild cases can be isolated at home; however it is unclear to what extent patients adhere to home isolation guidelines, and whether home isolation was in fact effective in reducing infection among the patient’s family contacts. Aim of the Work The aim of this study was: Describe the socio-demographic characteristics of asymptomatic and mild patients eligible for home isolation and measure the adherence of patients isolated at home to the recommended control measures with telemedicine follow up. Patients and Methods This is a retrospective cohort study conducted in Ain Shams University on 400 patients who were diagnosed as positive for covid-19, classified as asymptomatic or mild cases at presentation and recommended for home isolation. Results In our cohort, Patients that were adherent to home isolation guidelines had similar household infection rate to those with less compliance except for those who had more than one bathroom, household infection had significant negative correlation to number of bathrooms (p = 0.003) because the patient was able to have personal bathrooms. Regarding family members, 57.8% of cases had members with no symptoms of COVID-19 and 43.2 % had members with symptoms or positive test. Conclusion Our study was limited with the low number of patients from a single centre. However, our findings showed that self-isolation at home may be an alternative to manage mild cases or asymptomatic patients when applied with careful and close observation.

Comparative evaluation of baseline SOFA score and CURB-65 score in predicting patient severity and outcome in COVID-19 patients admitted to a tertiary care ICU

Introduction COVID-19 is primarily a pulmonary disease, but with significant and frequent systemic manifestations. Our study aims to assess, which scoring system on admission—Confusion, Uraemia, Respiratory Rate &gt; 30/min, Blood Pressure low, Age &gt; 65 years (CURB-65) or SOFA, better correlates with COVID-19-positive patient mortality. Methodology This prospective observational study was conducted in COVID-positive adult patients. Upon admission, patient demographics, clinical condition and laboratory investigations were noted. SOFA and CURB-65 scores were calculated for each patient and the patient was followed up till the final outcome—transfer or expiry. Results Out of the 100 patients included in our study, the majority belonged to the age group of 41–60 years, with a mean age of 51 years. A significant proportion of patients (83%) had at least 1 pre-existing co-morbidity. The absence of co-morbidity showed an association with improved survival. The overall mortality rate was 46%. Baseline SOFA and CURB-65 scores showed a correlation with patient outcome, but SOFA showed a greater strength of association. It was found that at a cut-off of a total SOFA score of ≥4, it predicts patient expiry with a sensitivity of 89% and a specificity of 72%. Discussion CURB-65 is a scoring system used for severity assessment, guide therapy and prognostication of patients with lower respiratory tract infection or pneumonia. SOFA, on the other hand, is an ICU score used in multi-system diseases used for evaluating disease progression and prognostication. Many authors have found that SOFA score correlates well with patient outcome, and a high SOFA on admission usually indicates poor prognosis.

Coronavirus disease and assisted reproduction in South Africa: a qualitative study

Objective: Little has been written about the effects of the coronavirus disease 2019 (COVID-19) pandemic on assisted reproduction services in low and middle-income countries. The purpose of this study was to investigate the immediate and long-term effects of assisted reproductive technology services in South Africa after 27 months of various lockdowns and restrictions associated with the pandemic. Methods: This article draws on data collected in 2020–2023 as part of a qualitative study of assisted reproduction within sub-Saharan Africa. Twenty-nine infertility specialists and other clinical staff including embryologists, clinic coordinators, ova donor coordinators, and nurses were interviewed and asked about the effects of the pandemic on their clinics and patients. A semistructured in-depth interview technique was used to collect the data. The analysis was conducted using the thematic analysis method. Result: Findings revealed that the immediate effects of the pandemic included the cancellations and deferral of assisted reproductive technology cycles and decreased numbers of cross-border patients. Challenges experienced by clinics in making decisions included whether to treat COVID-positive patients, increased costs of testing, and economic losses. Longer-term effects included the reconsideration of life priorities by both specialists and patients, and improved remote consultations and networking opportunities facilitated by the widespread dissemination of online platforms. There was also increased acceptability of the shipping and use of frozen gametes, leading to a perceived growth of the South African frozen oocyte trade. There was also decreased demand for add-ons, associated with the economic downturn post-pandemic in the region. Conclusion: COVID-19 carried costs (cancellation of cycles, a decrease in international patients, decrease in some procedures with the post-COVID economic downturn) but also unanticipated benefits for the practices and provision of services within infertility clinics in South Africa (increased gamete and embryo shipping; virtual patient consultations; improved virtual networking; greater use of local in vitro fertilization services). Further comparisons postpandemic in other low and middle-income countries are needed to understand the long-term implications.

Relationship between Ocular Manifestations and Chest pain: A frequency based analysis of Systemic and Ocular Signs in COVID-19 Patients

Objective: To find the frequencies of systemic and ocular signs in confirmed polymerase chain reaction (PCR) positive COVID-19 cases and to find association between ocular manifestation and systemic signs in Covid-19 patients. Study Design: A prospective cross-sectional study. Place and Duration: Department of Medicine and Ophthalmology, KRL Hospital Islamabad. The research lasted six months, from 1st January 2021 to 31st August 2021. Methodology: A total of 416 PCR-confirmed COVID-19 positive patients were included. As a sample strategy, purposive sampling was adopted. SPSS version 21 was used for statistical analysis. Descriptive statistics was calculated for continuous variables. Chi square test was applied to find association among systemic and ocular signs. Results: The study included 73% men, and 27% women. Patients presented with body aches 67%, sudden onset retrosternal chest pain 21.9%, abdominal pain 14.4%, ocular symptoms 10.3%, loss of taste 67%, and loss of smell 66.7%, loose motion 1.1% and shortness of breath in 1%. The patients' mean platelet counts were 230.30 ±65.63, mean lymphocyte counts were 3702 ±176, t mean total leucocyte counts (TLCs) were 7.524 ±5, and mean c-reactive protein (CRP) level was 21.816 with SD of ±25.992.Assessing the relation between ocular symptoms and other systemic symptoms, the Chi-square test revealed an insignificant relationship. However, it showed a significant association between chest pain and ocular symptoms with a p-Value 0.001. Conclusion: This study found a significant association between chest pain and conjunctivitis in COVID-19 patients, attributing chest pain to respiratory issues, inflammation, and blood clotting. Conjunctivitis was prevalent, especially in healthy, young individuals. Keywords: COVID-19, Chest Pain, Conjunctivitis, Ocular Symptoms.

Periodic Fasting and Acute Cardiac Events in Patients Evaluated for COVID-19: An Observational Prospective Cohort Study.

Periodic fasting was previously associated with greater longevity and a lower incidence of heart failure (HF) in a pre-pandemic population. In patients with coronavirus disease 2019 (COVID-19), periodic fasting was associated with a lower risk of death or hospitalization. This study evaluated the association between periodic fasting and HF hospitalization and major adverse cardiovascular events (MACEs). Patients enrolled in the INSPIRE registry from February 2013 to March 2020 provided periodic fasting information and were followed into the pandemic (n = 5227). Between March 2020 and February 2023, N = 2373 patients were studied, with n = 601 COVID-positive patients being the primary study population (2836 had no COVID-19 test; 18 were excluded due to fasting <5 years). A Cox regression was used to evaluate HF admissions, MACEs, and other endpoints through March 2023, adjusting for covariables, including time-varying COVID-19 vaccination. In patients positive for COVID-19, periodic fasting was reported by 180 (30.0% of 601), who periodically fasted over 43.1 ± 19.2 years (min: 7, max: 83). HF hospitalization (n = 117, 19.5%) occurred in 13.3% of fasters and 22.1% of non-fasters [adjusted hazard ratio (aHR) = 0.63, CI = 0.40, 0.99; p = 0.044]. Most HF admissions were exacerbations, with a prior HF diagnosis in 111 (94.9%) patients hospitalized for HF. Fasting was also associated with a lower MACE risk (aHR = 0.64, CI = 0.43, 0.96; p = 0.030). In n = 1772 COVID-negative patients (29.7% fasters), fasting was not associated with HF hospitalization (aHR = 0.82, CI = 0.64, 1.05; p = 0.12). In COVID-positive and negative patients combined, periodic fasting was associated with lower mortality (aHR = 0.60, CI = 0.39, 0.93; p = 0.021). Routine periodic fasting was associated with less HF hospitalization in patients positive for COVID-19.

Management of Peritoneal Dialysis-Associated Emergencies during the COVID-19 Pandemic: The Experience of a Center of Excellence.

The COVID-19 pandemic struck unexpectedly; emergency services and chronic care institutions, including dialysis centers, were overloaded. A significant problem was the care of COVID-positive patients alongside the care of chronically dialyzed patients who presented emergencies. In our hospital, which became a COVID support center for dialysis patients with severe forms of the disease, we had to care for PD patients with dialysis-related emergencies. We present two cases of patients managed on an outpatient basis or 1-day hospitalization who were treated successfully without compromising the quality of the care provided. We used remote monitoring, worked in a multidisciplinary team, and shortened the duration of the patients' hospitalization (and implicitly the risk of contact). In pandemic conditions, the advantage of PD was the possibility of patient isolation; in the first 6 months of the pandemic, we recorded no deaths in this category of patients. In hemodialysis patients, infection and mortality rates were high. Although we expected an increase in the number of peritoneal dialysis patients in the post-pandemic period, this did not happen. We continue to plead for the popularization of the PD method among patients and doctors, which has proven advantages in pandemic conditions.

A Bayesian Survival Analysis on Long COVID and non Long COVID patients: A Cohort Study Using National COVID Cohort Collaborative (N3C) Data.

Since the outbreak of COVID-19 pandemic in 2020, numerous researches and studies have focused on the long-term effects of COVID infection. The Centers for Disease Control (CDC) implemented an additional code into the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for reporting 'Post COVID-19 condition, unspecified (U09.9)' effective on October 1st 2021, representing that Long COVID is a real illness with potential chronic conditions. The National COVID Cohort Collaborative (N3C) provides researchers with abundant electronic health records (EHR) data by aggregating and harmonizing EHR data across different clinical organizations in the United States, making it convenient to build up a survival analysis on Long COVID patients and non Long COVID patients among large amounts of COVID positive patients.

Detection of COVID-19 by quantitative analysis of carbonyl compounds in exhaled breath

COVID-19 has caused a worldwide pandemic, creating an urgent need for early detection methods. Breath analysis has shown great potential as a non-invasive and rapid means for COVID-19 detection. The objective of this study is to detect patients infected with SARS-CoV-2 and even the possibility to screen between different SARS-CoV-2 variants by analysis of carbonyl compounds in breath. Carbonyl compounds in exhaled breath are metabolites related to inflammation and oxidative stress induced by diseases. This study included a cohort of COVID-19 positive and negative subjects confirmed by reverse transcription polymerase chain reaction between March and December 2021. Carbonyl compounds in exhaled breath were captured using a microfabricated silicon microreactor and analyzed by ultra-high-performance liquid chromatography-mass spectrometry (UHPLC-MS). A total of 321 subjects were enrolled in this study. Of these, 141 (85 males, 60.3%) (mean ± SD age: 52 ± 15 years) were COVID-19 (55 during the alpha wave and 86 during the delta wave) positive and 180 (90 males, 50%) (mean ± SD age: 45 ± 15 years) were negative. Panels of a total of 34 ketones and aldehydes in all breath samples were identified for detection of COVID-19 positive patients. Logistic regression models indicated high accuracy/sensitivity/specificity for alpha wave (98.4%/96.4%/100%), for delta wave (88.3%/93.0%/84.6%) and for all COVID-19 positive patients (94.7%/90.1%/98.3%). The results indicate that COVID-19 positive patients can be detected by analysis of carbonyl compounds in exhaled breath. The technology for analysis of carbonyl compounds in exhaled breath has great potential for rapid screening and detection of COVID-19 and for other infectious respiratory diseases in future pandemics.

The impact of cardiorespiratory fitness on COVID-19 related outcomes: the ETHOS Study

Abstract Background Comorbidities such as cardiovascular disease, diabetes, obesity and hypertension are associated with more severe COVID-19 outcomes, but the relative impact of cardiorespiratory fitness (CRF) on outcomes in COVID-positive patients is largely unknown. Objective To assess the association between objectively measured CRF and COVID-19-related health outcomes including mortality, hospitalization, and mechanical ventilation in non-COVID vaccinated patients. Design, Setting and Participants. Retrospective analysis of 750,302 subjects (23,140 [mean age 65.8±12.0 years] with a positive COVID-19 test between March 2020 and September 2021) who underwent a maximal exercise test between 1999 and 2020. Main Outcomes and Measures. Association between all-cause mortality, hospitalization due to COVID-19, and need for intubation with risk for severe COVID-19 outcomes after adjustment for 15 covariates. Subjects were stratified into five age-specific CRF categories (Least-fit, Low-fit, Moderate-fit, Fit and High Fit), based on peak metabolic equivalents achieved. Results During a median of follow-up of 100 days, 1,643 (7.1%) patients died, 4,995 (21.6%) were hospitalized, and 927 (4.0%) required intubation for COVID-19 related reasons. When compared to the Least-Fit subjects (referent), the Low-Fit, Moderately-Fit, Fit, and High-Fit subjects had hazard ratios for mortality of 0.82 (95% CI; 0.72-0.93), 0.73 (95% CI; 0.63-0.86), 0.61 (95% CI; 0.53-0.72), and 0.54 (95% CI; 0.45-0.65), respectively (Figure). Subjects who were more fit also had significantly lower need for hospital admissions and intubation. Similar patterns were observed for elderly subjects and subgroups with comorbidities including hypertension, diabetes, cardiovascular disease, and chronic kidney disease; for each of these conditions, those in the High-Fit category had mortality rates that were roughly half those in the Low-Fit category. Conclusion Among subjects positive for COVID-19, higher CRF had a favorable impact on survival, need for hospitalization, and need for intubation regardless of age, BMI, or the presence of comorbidities.

Evaluation of candidemia risk factors and Candida species distribution in intensive care units among patients with and without COVID-19.

To assess the risk variables related to the types of candidemia for each patient, who was admitted into the intensive care unit regardless of the patient with or without complete diagnosis of COVID-19, during the period of March 2019 to December 2022. The evaluation comparison of demographic and clinical data of COVID-19 positive and negative patients with candidemia confirmed in blood, 113 cases were assessed. Variables such as gender, age, age of hospitalization, history of hospitalization, concurrently infection, The acute physiology and chronic health evaluation-II scores, comorbidity checking, intubation, central venous catheter use, parenteral nutrition use, steroid use, antibiotic use, lymphopenia, and laboratory variables were evaluated. Candida species distribution, antifungal susceptibility in blood culture were determined. Coronavirus disease-19 was present in 62.8% of cases confirmed candidemia, and these cases were significantly different from COVID-19 negative cases. Significance was found in more intubation, central venous catheter use, parenteral nutrition, and steroid therapy in Group 2. There was no significance with species distribution and associated infection. In total, COVID-19 positive had higher hemoglobin, aspartate aminotransferase, alanine transaminase, and white blood cell levels, which may be associated with the possibility of revealing and controlling candidemia. Candida albicans and Candida Parapsilosis (C. parapsilosis) are the species seen in infected COVID-19 patients, while C. parapsilosis and Candida tropicalis are found in non-COVID-19 ones. Risk factors were intubation, parenteral nutrition, central venous catheter, and steroid in the COVID-19 group.