Diagnosis Of COVID-19 Research Articles

The Current Status of OCT and OCTA Imaging for the Diagnosis of Long COVID

The Current Status of OCT and OCTA Imaging for the Diagnosis of Long COVID

Deployment of mobile application using a novel CNN model for the detection of COVID-19 thoracic disease

In January 2021 and January 2022, COVID-19 caused roughly 13,000 and 6,000 deaths respectively per day. In August 2022, 26,000 deaths per day were estimated to be caused by COVID-19, followed by 13,000 deaths per day in February 2024. The timely identification and treatment of malignant diseases can potentially lower the mortality rate. Nonetheless, the use of manual methods for diagnosing these conditions requires a meticulous and comprehensive examination, making it susceptible to errors, burdensome for healthcare professionals, and time-intensive. Hence, the objective of this study is to design and deploy a novel deep-learning model for the detection of COVID-19 thoracic diseases. A Convolutional Neural Network (CNN) with less trainable parameters was implemented. This proposed model was deployed on a mobile device using Android Studio and Flutter for the detection of COVID-19 thoracic diseases. Specificity, accuracy, precision, sensitivity, f1-score, ROC, and PR curves were used to evaluate the model's performance. Moreover, the carbon footprint as well as how responsible the proposed model is according to Responsible AI rules was also assessed. The model's evaluation results show an overall accuracy of 93.27 %, specificity of 97.33 %, precision of 93.75 %, sensitivity of 94.42 %, F1-Score of 94.06 %, ROC rate of 98.0 %, PR rate of 96.8 %. The evaluation of the mobile application shows higher generalizability on the COVID-19 dataset. Also, the overall FACETS Score representing responsible AI is 83 % and the carbon footprint (representing the amount of carbon emission emitted into the environment during model training and testing) of 416.73 g with equivalent tree months of 0.45 was obtained. This application with better performance and a low carbon footprint was deployed using Android Studio and Flutter and can assist physicians in the diagnosis of COVID-19 and related diseases.

Severity Profile of COVID-19 in Hospitalized Pediatric Patients.

We aimed to describe the clinical characteristics associated with severity in children hospitalized with COVID-19. This was an epidemiological cohort study conducted in two hospitals, one of which was a reference center for the treatment of COVID-19 cases. Data were collected from the reports generated by the hospital epidemiology centers and the medical records of patients aged between 0 and 14 years with a diagnosis of COVID-19, hospitalized between March 2020 and June 2021. To analyze the association between the clinical profile and severity, the cases were classified as severe (severe and critical) and non-severe (asymptomatic, mild, and moderate). Of the 191 children followed up in the cohort, 73.3% developed the severe form. The percentage of children with oxygen saturation below 95% was 46.6%. In the multivariate analysis, a higher risk of severity was estimated among children with uncontrolled asthma (RR = 13.2), who were overweight or obese (RR = 3.21), who had cough symptoms (RR = 2.72), and those aged under one year (RR = 3.23). This result underscores the need to improve healthcare at every level for children and for the management of asthma and nutrition when considering children with this clinical profile who are diagnosed with COVID-19.

A Descriptive Analysis of the Use of Various Therapeutics in a Cohort of COVID-19 Patients and the Influence of Media Coverage

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impacted the healthcare system immensely throughout 2020-2022. Treatment practices varied in Texas, as guidelines were in flux. As a result, a variety of therapeutics were used. Many verified medications with scientific basis were trialed, while others were implemented despite a lack of scientific consensus. This study aimed to identify how practice patterns to treat and manage COVID-19 changed over time in a cohort of patients in the University of Texas Medical Branch hospital system. Methods: Ninety participants with a COVID-19 diagnosis were included in the analysis for this study. Data was collected by a retrospective chart review, and included medications administered before and during current admission. Medications were categorized as: antiviral, antibiotic, steroid, supplement, antibody, hydroxychloroquine, and others. Results: Differences in therapeutic use were identified based on hospitalization status (outpatient or inpatient) and month admitted. The largest difference in the antiviral remdesivir (78%), requiring intravenous administration for up to ten days. In the outpatient setting, antibiotics, primarily azithromycin, were quite common. Additionally, month-to-month variation in steroid use and antibiotic use was observed. Conclusion: This study shows that adapting medical guidelines and strong media coverage played a role in the clinical management of COVID-19 patients. At times, some ineffective medications were prescribed such as hydroxychloroquine. Medical leaders and news coverage should collaborate closely in future public health emergencies to prevent the prescription of ultimately ineffective and potentially hazardous treatments.

The effect of corticosteroids in developing active pulmonary tuberculosis among patients with COVID-19.

Corticosteroids can reduce the mortality rate among patients with severe COVID-19 pneumonia. However, opportunistic infections such as Mycobacterium tuberculosis are of concern, especially among those on high doses of corticosteroids. It is unknown whether the risk of developing subsequent TB infection is high or not among COVID-19 patients on high doses of corticosteroids. Hence, this study was conducted to address this gap of knowledge. We conducted a retrospective, cross-sectional study at the King Chulalongkorn Memorial Hospital from October 12, 2022 to June 30, 2023. Two hundred forty-three participants with documented COVID-19 diagnosis on high dose corticosteroids were enrolled into the study. Baseline characteristics and risk factors of developing TB were collected. The prevalence of TB was significantly different among participants with chronic kidney disease (CKD) stages 2-4 and chronic lung diseases. The incidence of TB post 1-year diagnosis of COVID-19 was 4 out of 243 patients (1.6%) or 1,646 cases per 100,000 person-year. The mortality rate among subsequent TB group was significantly much higher than the non-TB group (50% vs 0.4%; p-value = 0.001). COVID-19 participants on high doses of corticosteroids also were co-infected with other infections such as bacteria (37.1%), fungi (5.3%), and Pneumocystis jirovecii (PJP) (1.2%). We found that the incidence of TB in participants with COVID-19 on high doses of corticosteroids was 11 times higher than the general population. Therefore, we recommend screening for latent TB among these patients to prevent/early diagnose TB disease.

Prevalence and Association of Deep Vein Thrombosis on Clinical Outcomes Among COVID-19 Patients

Background Studies have shown that COVID-19 could lead coagulation defects, resulting in increased morbidity and mortality. In this study, we sought to estimate the prevalence of deep vein thrombosis (DVT) among COVID-19 hospitalizations and its effects on hospital outcomes using a large administrative database. Methods We conducted a retrospective analysis of the 2020 California State Inpatient Database. All hospitalizations ≥18 years and primary diagnosis of COVID-19 were included and were stratified into those with and without DVT. The main outcomes of the study were in-hospital mortality, prolonged length of stay, vasopressor use, mechanical ventilation, and intensive care unit admission. Results We included a total of 94,114 primary COVID-19 hospitalizations for the analysis. Among them, 1575 (1.7%) had DVT. After adjusting for covariates, regression analysis showed that those with DVT had significantly greater odds for mortality (adjusted odds ratio [aOR], 2.34; 95% confidence interval [CI], 2.07–2.65), prolonged length of stay (aOR, 3.51; 95% CI, 3.16–3.91), vasopressor use (aOR, 4.23; 95% CI, 3.78–4.74), mechanical ventilation (aOR, 2.90; 95% CI, 2.38–3.53), and intensive care unit admission (aOR, 4.32; 95% CI, 3.85–4.84). Conclusions In our cohort, though only a few COVID-19 hospitalizations had DVT, the risk for adverse outcome was significantly higher. Therefore, healthcare providers should promptly monitor for DVT among COVID-19 patients and manage it promptly.

Adopting Covid-19 and Flu Testing Strategies In An Underserved Community

Abstract Introduction/Objective The COVID-19 pandemic has had a significant impact on communities worldwide, while little is known about how medically underserved minority communities perceive and experience COVID-19 and/or COVID- 19/Flu combined testing. This research target at a medically underserved community in east Harris County, Texas, and was designed to 1) understand the perception of the single COVID-19 test as well as the COVID-19 and flu combined test, 2) implement different testing strategies in collaboration with the local community. Methods/Case Report Residents in the eligible communities who are age ≥ 18 years or older are recruited through community engagement groups and community originations. Participant’s demographic information, perception and histories of vaccination and testing were collected through a cross-sectional questionnaire. Participants willing to undergo testing were assisted by community health workers, who then collected feedback on test acceptability via follow-up questionnaires. Results (if a Case Study enter NA) A total of 325 individuals participated in the study from Sept 2022-June 2023. 52% of participants are minority ethnicity, including 35% African American and 17% Latino. 11% of participants are uninsured and 32% of participants are from households with income lower than 25,000 a year. We surveyed our participants on their opinion of COVID-19 and Flu testing and vaccination, majority of our participants have had more experience in COVID-19 (92% had been tested and 93% had been vaccinated) than Flu (64% had been tested and 85% had been vaccinated). 96% consider COVID-19 testing tolerable, with major barrier of being tested is fear of painful sampling (49%). PCR testing is the dominant testing method in the community (> 40%) for COVID-19, while only 16% received antigen testing. Conclusion Our findings suggest that while participants recognized the role of COVID-19 testing, there were significant barriers to access and uptake of testing, including concerns about painful sampling, inconvenience, and a lack of trust in the healthcare system. Participants also expressed a desire for clearer information about testing and more accessible testing sites. Participants have less experience with Flu testing and many of whom had never been tested in the past. Our study highlights the need for targeted community education and outreach efforts to increase testing uptake. Development and implementation of these efforts would better prepare us for combating other commutable diseases of public health significance in the future.

Higher Serum Level of MMP-3 and Homocysteine in Patients Admitted With COVID-19

Background: SARS-CoV-2 predominantly affects the lungs, leading to severe acute respiratory syndrome (ARDS). The lack of specific biomarkers underscores the urgent need for novel indicators for early diagnosis and severity assessment of COVID-19. Specific Background: Matrix metalloproteinase-3 (MMP-3) is implicated in various inflammatory diseases, particularly viral infections, while homocysteine (Hcy) plays a crucial role in maintaining cell homeostasis and regulating inflammatory responses. Knowledge Gap: Despite their relevance in inflammation, the potential of MMP-3 and Hcy as biomarkers for COVID-19 remains underexplored. Aims: This study aimed to evaluate the serum levels of MMP-3 and Hcy in COVID-19 patients and assess their utility in diagnosis and severity prediction. Results: A study analyzing 90 serum samples from 60 ICU patients and 30 healthy controls found elevated CRP levels, higher Hcy and MMP-3 levels in the moderate group, but lower in the ICU group, with a significant correlation between MMP-3 activity and Hcy levels. Novelty: This research highlights the potential role of MMP-3 and Hcy as valuable biomarkers for COVID-19 diagnosis. Implications: While MMP-3 and homocysteine may aid in the diagnostic process, they could not be reliably used to predict severity outcomes in COVID-19 patients. Further studies are warranted to clarify the clinical implications of these biomarkers in the context of COVID-19. Highlights: MMP-3 and homocysteine identified as potential COVID-19 biomarkers. No correlation found between biomarkers and disease severity. Further research needed for clinical utility assessment. Keywords: COVID-19, MMP-3, homocysteine, biomarkers, diagnosis

Differences in COVID-19 Vaccination and Experiences among Patients with Hypertension in Colombia and Jamaica during the COVID-19 Pandemic.

During the COVID-19 pandemic, hypertensive patients had increased infection and healthcare disruption in many low- and middle-income countries (LMICs) with limited vaccine access. The objective of this report is to describe COVID-19 experiences and vaccination uptake among hypertensive patients in Colombia and Jamaica. A cross-sectional study of patients with hypertension was conducted in primary care clinics in both countries between 2021 and 2022. Trained interviewers used a telephone-administered questionnaire to assess COVID-19 experiences (infection, vaccination, and healthcare access). A total of 576 patients (68.5% female, mean age: 67.5 years) participated. Health service disruption affecting access to care was low (<10%). Compared to Jamaica, more participants from Colombia reported testing positive for COVID-19, having family members or friends testing positive, losing family members or friends due to COVID-19, and being vaccinated. In logistic regression models, adjusted for age, sex, education, and rural/urban clinic status, fear of COVID-19 (OR 2.7, 95% CI: 1.2-6.1) and residence in Colombia (OR 5.9, 95% CI: 2.4-14.6) were associated with higher vaccination uptake. Disparities in access to COVID-19 testing and diagnosis may have influenced these country differences including fear of COVID-19 and vaccine uptake. Other factors need to be better understood to prepare for future pandemic responses.

LITERATURE REVIEW: THE OMICS STUDY FOR DETERMINING BIOMARKERS IN HUMAN SERUM AND PLASMA WITH DIFFERENT COVID-19 SEVERITY

The severity of COVID-19 provides information on various stages of changes in the body's normal state in various parameters called biological markers (biomarkers) as the initial identification that facilitates management, selection, and total outcomes in therapy. These biomarkers were selected from the selection of samples that are often used in the advanced diagnosis of COVID-19, serum and plasma. This study aims to determine what biomarkers are measured in serum and plasma samples of COVID-19 patients. This literature review is classified as non-experimental, qualitative, and descriptive research. The inclusion criteria are the full-text journals published within the last two years regarding biomarkers in the serum and plasma of COVID-19 patients. Based on these criteria, 49 relevant articles were obtained. The results show that changes occur in the protein, lipid, and metabolite in serum and plasma by the omics approach. These alterations can be in the form of increasing or decreasing levels of each parameter determined through various analytical methods. The biomarkers profile correlates with the severity of COVID-19 as well as with host cells.

Relative Effectiveness and Waning of a Third Dose of mRNA COVID-19 Vaccine in Medicare Beneficiaries Aged 65 Years and Older during the BA.1/BA.2 Omicron Period.

We assessed the added benefit and waning effectiveness of a third COVID-19 vaccine dose (original formula) for preventing COVID-19-related outcomes. We used Medicare claims data to conduct a retrospective cohort study in U.S. community-dwelling Medicare Fee-for-Service beneficiaries aged ≥65 years during the BA.1/BA.2 Omicron period (December 19, 2021 - March 26, 2022). We estimated relative vaccine effectiveness (RVE) of 3 versus 2 doses of mRNA COVID-19 vaccines using marginal structural Cox regression models. Among 8,135,020 eligible beneficiaries, 73.3% were 3-dose vaccinated by March 26, 2022. At 14-60 days since vaccination, a third dose provided significant added benefit against COVID-19-related hospitalization for Moderna (RVE: 77.2%; 95% confidence interval (CI): 76.0%, 78.4%) and Pfizer-BioNTech (RVE: 72.5%; 95% CI: 70.8%, 74.0%). Added benefit was lower >120 days. For those with prior medically attended COVID-19 diagnoses, Pfizer-BioNTech provided an added benefit for 120 days, while Moderna provided some added benefit >120 days. Added benefit for either vaccine was higher against death compared to less severe outcomes, which still decreased >120 days. A third dose COVID-19 vaccine provided significant added benefit against COVID-19-related hospitalization and death, even for beneficiaries with prior medically attended COVID-19 diagnoses. This added benefit decreased after 4 months.

Primary healthcare services' accessibility and quality under compulsory social health insurance in Kazakhstan.

Between 2020 and 2022, there was a rise in employment and entrepreneurial activity, despite some unemployment growth. In the Compulsory Social Health Insurance (CSHI), insured individuals, especially privileged and wage workers, increased. However, certain contributors, like those exempt from contributions and single social taxpayers, decreased, possibly due to legislative changes or the economic climate. The study aimed to evaluate the effectiveness and accessibility of medical services within the frameworks of Compulsory Social Health Insurance and the state Guaranteed volume of free medical care based on data regarding waiting times and the volume of services provided. This retrospective study analyzed data from 2020 to 2022 on patients receiving care under Kazakhstan's Mandatory Social Medical Insurance System (MSMIS) and Guaranteed Volume of Free Medical Care. Data included insurance status, labor market indicators, and medical service procurement. Descriptive statistics were calculated, and t-tests, with p-values indicating statistical significance (p < 0.05). It has been identified that overall, the execution of the plan for all types of medical care in Kazakhstan, including Almaty, reaches 100.0%, indicating sufficient financial support for the healthcare system. Rehabilitation centers and COVID-19 testing services stand out with shorter waiting times, whereas comprehensive diagnostic and advisory services require significantly longer waiting periods. The Guaranteed Volume of Free Medical Care typically offers a greater number of services with shorter waiting times compared to MSMIS, except for specialized medical care services in diagnosing new formations, where the Guaranteed Volume of Free Medical Care also has shorter waiting times but provides a greater number of services. The study has allowed us to identify differences in the availability and volume of medical services provided between Compulsory Social Health Insurance and the state Guaranteed volume of free medical care.

Uptake, Acceptability, and Results of SARS-CoV-2 Antigen Rapid Diagnostic Testing in Community Settings in Cameroon.

Mass gathering event restrictions were part of mitigation measures during the COVID-19 pandemic that were lifted as prevalence decreased and after vaccination rollout. We explored SARS-CoV-2 antigen rapid diagnostic test acceptability and positivity in community settings in Cameroon. In August-October 2022, community workers sensitized and referred individuals for COVID-19 testing to nearby testing points in Douala and Yaoundé. Participants consented to SARS-CoV-2 antigen rapid diagnostic testing, a survey, or both components. We describe the positivity rate, COVID-19-related history, and Likert-scale testing perceptions. Factors associated with testing acceptance were analyzed using logistic regression. Overall, 20.5% (2,449/11,945) of sensitized individuals visited testing points, and 1,864 (76.1%) were enrolled; 50.6% accepted the survey and testing (46.0% accepted survey only). Seven (0.7%) of 1,006 individuals tested positive. Most (71.8%; 1,292/1,800) considered community testing more accessible than hospital-based testing. Individuals accepting versus refusing testing differed in perceived COVID-19 risk (67%, 49%; P <0.001), belief in accurate test results (79%, 47%; P <0.001), and ability to test easily (96%, 55%; P <0.001). Males (adjusted odds ratio [aOR]: 1.26 [1.04-1.53]) and those over 50 years (aOR: 1.9 [1.4-2.7]), with symptoms (aOR: 1.80 [1.30-2.50]), and at least partial vaccination (aOR: 0.76 [0.58-0.99]) were significantly associated with test acceptance. Refusal reasons included lack of perceived need for testing (33.8%) and testing discomfort (26.3%). Although community-based testing was generally perceived as important, actual testing uptake was low. In future pandemics, community testing should be optimized by addressing misinformation, offering alternative testing modalities for greater comfort, creating demand, and tailoring approaches to maximize testing uptake.

SARS-CoV-2 Infection and New-Onset Type 2 Diabetes Among Pediatric Patients, 2020 to 2022

In adults, diagnoses of new-onset type 2 diabetes (T2D) have increased following diagnosis with COVID-19, but whether this occurs in children is unclear. To determine whether risk of incident T2D diagnosis is increased during the 6 months after SARS-CoV-2 infection among children. This retrospective cohort study used electronic health records from the TriNetX analytics platforms between January 1, 2020, and December 31, 2022. Pediatric patients aged 10 to 19 years without preexisting diabetes were eligible for inclusion. Data were analyzed from August 15 to September 15, 2023, with supplemental analyses January 20 and August 8 to 13, 2024. Diagnosis of COVID-19 or a non-COVID-19 respiratory infection. New diagnosis of T2D compared by risk ratios (RRs) and 95% CIs at 1, 3, and 6 months after index infection. The main study population included 613 602 patients, consisting of 306 801 with COVID-19 (mean [SD] age at index, 14.9 [2.9] years; 52.8% female) and 306 801 with other respiratory infections (ORIs) but no documented COVID-19 (mean [SD] age at index, 14.9 [2.9] years; 52.6% female) after propensity score matching. Risk of a new diagnosis of T2D was significantly increased from day of infection to 1, 3, and 6 months after COVID-19 diagnosis compared with the matched cohort with ORIs (RR at 1 month, 1.55 [95% CI, 1.28-1.89]; RR at 3 months: 1.48 [95% CI, 1.24-1.76]; RR at 6 months: 1.58 [95% CI, 1.35-1.85]). Similar results were found in the subpopulation classified as having overweight or obesity (RR at 1 month: 2.07 [95% CI, 1.12-3.83]; RR at 3 months: 2.00 [95% CI, 1.15-3.47]; RR at 6 months: 2.27 [95% CI, 1.38-3.75]) and the hospitalized subpopulation (RR at 1 month: 3.10 [95% CI, 2.04-4.71]; RR at 3 months: 2.74 [95% CI, 1.90-3.96]; RR at 6 months: 2.62 [95% CI, 1.87-3.66]). Similar elevation in risk was found at 3 and 6 months when excluding patients diagnosed during the interval from the index date to 1 month after infection. In this retrospective cohort study of children and adolescents aged 10 to 19 years, the risk of an incident diagnosis of T2D was greater following a COVID-19 diagnosis than in children diagnosed with ORIs. Further study is required to determine whether diabetes persists or reverses later in life.

Feasibility, Acceptability, Satisfaction, and Challenges of an mHealth App (e-ASCov) for Community-Based COVID-19 Screening by Community Health Workers in Rwanda: Mixed Methods Study.

Although at the base of the pyramid-shaped organization of the Rwandan health system, community health workers (CHWs) are central to the community-based management of disease outbreaks. This mixed methods study aimed to explore the feasibility, acceptability, satisfaction, and challenges of a mobile health (mHealth) tool for community-based COVID-19 screening in Rwanda. Two urban (Gasabo and Nyarugenge) and 2 rural (Rusizi and Kirehe) districts in Rwanda participated in the project (smartphone app for COVID-19 screening). A mixed methods approach was used to inform the feasibility (awareness and expectation), acceptability (use and perceived benefits), satisfaction, and challenges of the mHealth intervention. At the end of the project, CHWs were asked to complete a quantitative questionnaire on the use of and satisfaction with the app. Then, in-depth interviews and focus group discussions were organized with CHWs. A content analysis was performed on the transcripts. Overall, 383 CHWs were recruited and trained; 378 CHWs participated in the study. The mean age of CHWs was 36.7 (SD 6.6) to 45.3 (SD 9.9) years and most were women (237/378, 62.7%). More than 7000 people were registered with the use of the app and 20% were referred to a local COVID-19 testing facility. According to CHW reporting, the median number of people screened by each CHW ranged from 152 (IQR 70-276) for Nyarugenge to 24 (IQR 16-90) for Rusizi. COVID-19 positivity rates were higher in urban than rural districts: more than half of the CHWs in Gasabo reported a confirmed positive case versus only 2.4% for Kirehe and 15.4% for Rusizi. Despite the app being a novel tool, CHWs were well aware of the use of such a tool and had appropriate expectations. Acceptability and satisfaction were very high, with differences between urban and rural districts. Satisfaction was higher in Nyarugenge (72.8/100) and Gasabo (80.7/100) than in Kirehe (61.6/100) and Rusizi (64.5/100). More than 80% of the CHWs were willing to continue using the e-ASCov app, with the exception of CHWs in Kirehe (56.7%). The app was perceived as a tool to generate information on COVID-19, inform on the status of the pandemic, and help curb the spread of the pandemic in Rwanda. CHWs were satisfied with the app at all stages of its implementation in their districts. In this proof-of-concept study, a smartphone app for screening COVID-19 was useful as an mHealth tool to be used by CHWs, with the potential to increase health system efficiency in an epidemic context. The context should be analyzed for generalization on a country-wide scale, both in case of an epidemic and to take into account certain conditions at the community level. Information is needed on the conditions of generalization and transferability of this type of app to other health conditions so that CHWs can be given their full place in a pyramidal health system.

SARS-CoV-2 infection and the risk of depressive symptoms: a retrospective longitudinal study from the population-based CONSTANCES cohort.

Should COVID-19 have a direct impact on the risk of depression, it would suggest specific pathways for prevention and treatment. In this retrospective population-based study, we aimed to examine the association of prior SARS-CoV-2 infection with depressive symptoms, distinguishing self-reported v. biologically confirmed COVID-19. 32 007 participants from the SAPRIS survey nested in the French CONSTANCES cohort were included. COVID-19 was measured as followed: ad hoc serologic testing, self-reported PCR or serology positive test results, and self-reported COVID-19. Depressive symptoms were measured with the Center of Epidemiologic Studies-Depression Scale (CES-D). Outcomes were depressive symptoms (total CES-D score, its four dimensions, and clinically significant depressive symptoms) and exposure was prior COVID-19 (no COVID-19/self-reported unconfirmed COVID-19/biologically confirmed COVID-19). In comparison to participants without COVID-19, participants with self-reported unconfirmed COVID-19 and biologically confirmed COVID-19 had higher CES-D scores (β for one interquartile range increase [95% CI]: 0.15 [0.08-0.22] and 0.09 [0.05-0.13], respectively) and somatic complaints dimension scores (0.15 [0.09-0.21] and 0.10 [0.07-0.13]). Only those with self-reported but unconfirmed COVID-19 had higher depressed affect dimension scores (0.08 [0.01-0.14]). Accounting for ad hoc serologic testing only, the CES-D score and the somatic complaints dimension were only associated with the combination of self-reported COVID-19 and negative serology test results. The association between COVID-19 and depressive symptoms was merely driven by somatic symptoms of depression and did not follow a gradient consistent with the hypothesis of a direct impact of SARS-CoV-2 infection on the risk of depression.

Exploring differences in perceived barriers and facilitators to COVID-19 vaccine uptake and testing intention by vaccination status and testing hesitancy among rural Latino communities in Southwest Florida

ABSTRACT Background: Identifying factors impacting vaccination and testing for COVID-19 is crucial to reduce health disparities, especially for rural/agricultural, low access and high poverty Latino communities disproportionately affected by the pandemic. This study examined differences in perceived barriers and facilitators (such as values, beliefs, and concerns) to COVID-19 vaccine uptake and testing intention by vaccination status and testing hesitancy among rural Latino community members in Southwest Florida. Methods: Rural Latino community members (N = 493) completed a cross-sectional survey in Spanish (86.0%) or English (14.0%) on perceived COVID-19 vaccine/testing barriers and facilitators, as well as demographics, mental health, medical history, health perceptions, and health literacy. Results: At the time of the survey, approximately 43% of participants were unvaccinated and 46.4% were testing hesitant. Significantly more vaccinated participants acknowledged keeping their family (d = .25), community (d = .27), and themselves (d = .22) safe as facilitators to vaccination (ps < .001). Among the unvaccinated participants, the most common concerns for getting vaccinated were side effects (d = −.53) and lack of knowledge about how the vaccine works (d = −.35, ps < .001). Testing hesitant participants reported concerns including not knowing where to get tested (d = −.25, p = 0.01) and less confidence in a positive test result (d = −.40, p < 0.001). Doctors and faith leaders were ranked as the most trusted information sources across groups. In logistic regression models, vaccination was linked to age, gender, education, and protecting others, while concerns about needles and side effects reduced odds; testing was driven by education, anxiety, hope, and safety concerns. Conclusion: Promoting family and community safety may be effective facilitators influencing vaccine and testing intention in rural Latino communities. Enhanced education by trusted information sources, such as doctors and faith leaders may alleviate associated concerns. Our findings may inform actions for future pandemics. Further studies should determine the generalizability of our findings across other rural migrant communities and other vaccines.

Acoustic and Clinical Data Analysis of Vocal Recordings: Pandemic Insights and Lessons.

Background/Objectives: The interest in processing human speech and other human-generated audio signals as a diagnostic tool has increased due to the COVID-19 pandemic. The project OSCAR (vOice Screening of CoronA viRus) aimed to develop an algorithm to screen for COVID-19 using a dataset of Portuguese participants with voice recordings and clinical data. Methods: This cross-sectional study aimed to characterise the pattern of sounds produced by the vocal apparatus in patients with SARS-CoV-2 infection documented by a positive RT-PCR test, and to develop and validate a screening algorithm. In Phase II, the algorithm developed in Phase I was tested in a real-world setting. Results: In Phase I, after filtering, the training group consisted of 166 subjects who were effectively available to train the classification model (34.3% SARS-CoV-2 positive/65.7% SARS-CoV-2 negative). Phase II enrolled 58 participants (69.0% SARS-CoV-2 positive/31.0% SARS-CoV-2 negative). The final model achieved a sensitivity of 85%, a specificity of 88.9%, and an F1-score of 84.7%, suggesting voice screening algorithms as an attractive strategy for COVID-19 diagnosis. Conclusions: Our findings highlight the potential of a voice-based detection strategy as an alternative method for respiratory tract screening.

Prevalence of Vitamin D Deficiency in Patients with Fatigue and Neuropsychiatric Symptoms of Long COVID and its Correlation with Symptom Severity

Background: Despite the potential role of vitamin D in the acute phase of COVID-19, studies on its prevalence and association with long COVID severity are limited, leaving the relationship between vitamin D levels and long COVID symptoms unclear. Aim: The objective of this study was to investigate the prevalence of vitamin D deficiency in patients with fatigue or neuropsychiatric symptoms of long COVID and its correlation with the severity of symptoms. Methods: A cross-sectional, single-center study was conducted at Thammasat University Hospital, Thailand. The study recruited participants between the ages of 18 and 60 years who had received a diagnosis of COVID-19 and had at least one long COVID symptom, including fatigue or neuropsychiatric symptoms. Vitamin D level was collected, and clinical severity was assessed using the Chalder Fatigue Scale [CFQ-11], Depression, Anxiety and Stress Scale-21 Items [DASS-21], Pittsburgh Sleep Quality Index [PSQI], Addenbrooke's Cognitive Examination III [ACE], and Trail Making Test A &amp; B [TMT-A and TMT-B]. Results: A total of 82 patients were recruited; most were female [78%], with a mean age of 34.2 years. Most participants had a vitamin D deficiency [&lt;20 ng/mL, 73.2%], accounting for 23.2% vitamin D insufficiency [20-30 ng/mL], and 3.6% had an adequate vitamin D level. Only gender was associated with vitamin D levels. Multivariable analysis demonstrated that the vitamin D level was not correlated with all clinical outcomes, including total CFQ, total DASS, DASS depression, DASS anxiety, total PSQI, total ACE score, and total TMT scores. Conclusion: The prevalence of vitamin D insufficiency and deficiency was high in patients with long COVID, with female gender serving as predictors of lower vitamin D levels. However, no associations were found between vitamin D level and fatigue syndrome, depression, anxiety, sleep problems, or cognitive function.

Polypurine reverse hoogsteen hairpins as a therapeutic tool for SARS-CoV-2 infection

Although COVID-19 pandemic was declared no longer a global emergency by the World Health Organization in May 2023, SARS-CoV-2 is still infecting people across the world. Many therapeutic oligonucleotides such as ASOs, siRNAs or CRISPR-based systems emerged as promising antiviral strategies for the treatment of SARS-CoV-2. In this work we explored the inhibitory potential on SARS-CoV-2 replication of Polypurine Reverse Hoogsteen Hairpins (PPRHs), CC1-PPRH and CC3-PPRH, targeting specific polypyrimidine sequences within the replicase and Spike regions, respectively, and previously validated for COVID-19 diagnosis. Both PPRHs bound to their target sequences in the viral genome with high affinity in the order of nM. In vitro, both PPRHs reduced viral replication by more than 92% when transfected into VERO-E6 cells 24 hours prior infection with SARS-CoV-2. In vivo intranasal administration of CC1-PPRH in K18-hACE2 mice expressing the human ACE receptor protected all the animals from SARS-CoV-2 infection. The properties of PPRHs position them as promising candidates for the development of novel therapeutics against SARS-CoV-2 and other viral infections.