Current Coronavirus Disease Of 2019 Research Articles

The OM-85 bacterial lysate: a new tool against SARS-CoV-2?

The emergence of SARS-CoV-2, a novel coronavirus, caused the global Coronavirus disease of 2019 (COVID-19) pandemic. Because SARS-CoV-2 mutates rapidly, vaccines that induce immune responses against viral components critical for target cell infection strongly mitigate but do not abrogate viral spread, and disease rates remain high worldwide. Complementary treatments are therefore needed to reduce the frequency and/or severity of SARS-CoV-2 infections. OM-85, a standardized lysate of 21 bacterial strains often found in the human airways, has immuno-modulatory properties and is widely used empirically in Europe, South America and Asia for the prophylaxis of recurrent upper airway infections in adults and children, with excellent safety profiles. In vitro studies from our laboratory recently demonstrated that OM-85 inhibits SARS-CoV-2 epithelial cell infection by downregulating SARS-CoV-2 receptor expression, raising the possibility that this bacterial extract might eventually complement the current COVID-19 therapeutic toolkit. Here we discuss how our results and those from other groups are fostering progress in this emerging field of research.

Rare disease emerging as a global public health priority.

The genomics revolution over the past three decades has led to great strides in rare disease (RD) research, which presents a major shift in global policy landscape. While RDs are individually rare, there are common challenges and unmet medical and social needs experienced by the RD population globally. The various disabilities arising from RDs as well as diagnostic and treatment uncertainty were demonstrated to have detrimental influence on the health, psychosocial, and economic aspects of RD families. Despite the collective large number of patients and families affected by RDs internationally, the general lack of public awareness and expertise constraints have neglected and marginalized the RD population in health systems and in health- and social-care policies. The current Coronavirus Disease of 2019 (COVID-19) pandemic has exposed the long-standing and fundamental challenges of the RD population, and has reminded us of the critical need of addressing the systemic inequalities and widespread disparities across populations and jurisdictions. Owing to the commonality in goals between RD movements and universal health coverage targets, the United Nations (UN) has highlighted the importance of recognizing RDs in policies, and has recently adopted the UN Resolution to promote greater integration of RDs in the UN agenda, advancing UN's commitment in achieving the 2030 Sustainable Development Goals of "leav[ing] no one behind." Governments have also started to launch Genome Projects in their respective jurisdictions, aiming to integrate genomic medicine into mainstream healthcare. In this paper, we review the challenges experienced by the RD population, the establishment and adoption of RD policies, and the state of evidence in addressing these challenges from a global perspective. The Hong Kong Genome Project was illustrated as a case study to highlight the role of Genome Projects in enhancing clinical application of genomic medicine for personalized medicine and in improving equity of access and return in global genomics. Through reviewing what has been achieved to date, this paper will provide future directions as RD emerges as a global public health priority, in hopes of moving a step toward a more equitable and inclusive community for the RD population in times of pandemics and beyond.

Coronavirus Disease of 2019 (COVID-19) Outbreak Investigation Findings from an Urban Skilled Nursing Facility

The current COVID-19 pandemic has disproportionately affected nursing home (NH) residents. While vaccination has offered protection against severe disease, sporadic outbreaks continue to occur in skilled nursing facilities (SNF). We present NH resident characteristics from one such outbreak that occurred in October/November 2021.

Leave no one behind: inclusion of alpha-1 antitrypsin deficiency patients in COVID-19 vaccine trials.

The coronavirus disease of 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, continues to present an unprecedented challenge worldwide. Emerging evidence suggests that α-1 antitrypsin (A1AT), a circulating protein with protective effects on the lung and other vital organs, plays a critical role in preventing SARS-CoV-2 infection and may be a promising therapeutic option for patients with COVID-19. A1AT deficiency (AATD) is characterized by dysfunctional or insufficient levels of A1AT. Recently, we have proposed that AATD patients are a vulnerable population for COVID-19. Patients with AATD may derive limited benefit from the current COVID-19 vaccines and continue to rely on conventional medical therapy and behavioral adaptations to mitigate the risk of infection. Unfortunately, this population has not been included in the COVID-19 vaccine clinical trials and studies have yet to characterize the safety, immunogenicity, and ultimately, the efficacy of COVID-19 vaccines for AATD patients. Re-evaluation of the COVID-19 vaccine safety and immunogenicity will further promote informed decision-making for vaccination in AATD individuals and contribute to reduce morbidity and mortality from COVID-19 infection.

Mentorship amid the Madness: The Value of National Mentorship Programs in Plastic Surgery amid the COVID-19 Pandemic.

Coronavirus disease of 2019 (COVID-19) has spread rapidly throughout the world, and the impact on global and national health care, including plastic surgery, has been dramatic and unpredictable. Plastic surgery departments and divisions went into limbo after the American College of Surgeons, American Society of Plastic Surgeons, and The Aesthetic Society, advised that elective and nonessential cases be canceled.1 All large plastic surgery meetings were canceled. Aspiring plastic surgeon trainees are among those affected by the pandemic; the Association of American Medical Colleges called for a halt in all clinical rotations of at least 4 weeks’ duration in the 2020/2021 application cycle, a critical time for fourth-year medical students applying to integrated plastic surgery programs.2 Medical students typically dedicate April to September rotating as subinterns on the plastic surgery service at their home institution and at several “away institutions” throughout the United States. Away rotations play a significant role in the plastic and reconstructive surgery match process; 67 percent of successful applicants in a given year participated in a rotation at the institution they matched into.3 Students also attend national meetings for the opportunity to present their research, meet renowned faculty members across the country, and receive feedback on their application and performance. Often faculty, residents, and students at such events become lifelong colleagues and mentors.4,5 These opportunities are now no longer available for students applying in the current COVID-19 pandemic. Plastic surgery residency applicants applying in the 2020/2021 cycle era are facing the daunting unknown with more limited opportunities for meeting influential individuals in the field. Students at institutions that do not have a plastic surgery home program may be affected the most. Consequently, mentorship of future trainees is arguably more important than ever, as it provides prospective applicants with a unique opportunity to connect students with faculty across the country to discuss research and personal career development and to expand one’s network of mentors and colleagues. In 2015, the Plastic Surgery Research Council established a formal mentorship program with the goal of facilitating relationships between trainees and senior figures and of fostering unique guidance regarding career development. Medical student members and plastic surgery applicants can be paired with mentors across the nation from diverse backgrounds, and mentors can provide invaluable advice electronically regarding research endeavors and residency applications. With the current restrictions imposed by the evolving COVID-19 pandemic, electronic mentee-mentor interactions may be the only chance that prospective plastic surgery residents have to appreciate and converse with faculty and residents from different institutions, We thus want to emphasize the value of mentorship relationships and formal mentorship programs such as that offered by the Plastic Surgery Research Council. It is critically important to connect medical students/trainees with faculty members to help them learn the nuances of plastic surgery programs in institutions across the nation. Reaching beyond the classroom and expanding our horizons can help us confront the realities we could not have anticipated. DISCLOSURE The authors have no potential conflicts of interest to disclose.

Multisystem inflammatory syndrome in children during the coronavirus disease pandemic of 2019: a review of clinical features and acute phase management.

The current coronavirus disease of 2019 (COVID-19) pandemic has presented unique health challenges in the pediatric population. Compared to adults, the most significant change in viral disease manifestation is encompassed by the multisystem inflammatory syndrome in children (MIS-C). MIS-C is a new inflammatory syndrome which develops 2–4 weeks after COVID-19 exposure, with evidence suggesting it is a post-infectious immune reaction. We describe its epidemiology, pathophysiology, diagnosis (which varies based on definition used) and treatment options based on published recommendations. A systematic literature search we conducted through MEDLINE yielded 518 abstracts and identified five studies that reported more than 100 cases of MIS-C and their mortality. Most cases developed multiorgan dysfunction, including cardiovascular, dermatologic, neurological, renal, and respiratory issues, and required intensive care unit (ICU) admission. Many patients admitted to the ICU needed inotrope support and invasive mechanical ventilation, and the most severe cases required extracorporeal membrane oxygenation support. Most clinicians treated MIS-C with intravenous immunoglobulin, systemic steroids, and biological therapies. Overall mortality was low (2–3%) in all studies. Further research is needed to: understand if early intervention can prevent its progression; optimize its treatment; and improve outcomes of this new syndrome for the patients who develop MIS-C.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00540-021-02952-6.

Impact of COVID-19 on Cardiovascular Patients and Review of Current COVID-19 Treatment Strategies

Coronavirus disease of 2019 (COVID-19) has severely affected global health and caused a significant health burden worldwide, particularly in patients with cardiovascular insult. Worldwide, the COVID-19 confirmed cases number reached 81,658,440 cases with 1,802,206 deaths stated to the world health organization by January 1, 2021. Many risk factors, such as the elderly, diabetes, chronic kidney disease (CKD), and cardiovascular illness, like coronary disease, cardiomyopathy, and hypertension; put people at high vulnerability with COVID-19 infection. Many cardiovascular insults directly occur because of COVID-19 infection as myocarditis, pericarditis, heart failure, myocardial infarction, thromboembolic events, or arrhythmias. This review aims to shed light on different management modalities for COVID-19 and discuss the impact of COVID-19 on underlying cardiovascular comorbidities. Our hope lies in the COVID-19 vaccine as the best promising plan against the pandemic with the antiviral medications. Till the availability of antiviral agents and effective vaccines, repurposing drugs therapy would continue to be the mainstream. Cardiovascular diseases may be caused by or precedent conditions in COVID-19 patients. The physicians and the medical staff should be up-to-date regarding probable complications with COVID-19.

Impact of COVID-19 Pandemic on Health Services Provided to Elderly Population in Saudi Arabia

Background: Pandemics are not becoming infrequent events anymore. It is estimated that over 12,000 outbreaks have occurred since the year 1980, thanks to ease of travel and change in land use (Smith et al., 2014; Joes et al., 2008). The current coronavirus disease of 2019 (COVID-19) pandemic have exposed the lack of preparedness in well-connected, economically stable, developed countries. All aspects of life have changed dramatically. COVID-19 infection affects older adults with higher morbidity and mortality and those with chronic underlying medical disorders [Zhang et al., 2020]. There is an indirect effect of COVID-19 pandemic on elderly, related to quarantine and social isolation. Prolonged social isolation leads to several neurological, psychological, and medical morbidities in the elderly [Plagg et al., 2020]. On the other hand, hospital-based and community-based medical care for acute and chronic diseases was disrupted substantially during the pandemic, adding to the suffering endured by older adults. Such impact received little focus in contemporary research, especially in Saudi Arabia. Objectives: The main aim of our current investigation is to evaluate the impact of quarantine and medical care disruption on geriatric health during the COVID-19 pandemic in Saudi Arabia. Materials and Methods: We surveyed the elderly population in Saudi Arabia using a pre-designed electronic online questionnaire in Arabic language. The items were developed by collaborating with practicing family physicians, geriatricians affiliated to King Khalid University, and with service users. The link to the questionnaire was released unto social media and the elderly -and their carers- were encouraged to participate in the study. We collected sociodemographic as well as clinical data. A pilot study was conducted for a period of two months before the final version of the research tool was released. We utilized χ2 tests to evaluate the effect of categorical demographic and clinical variables. Statistical tests were 2-tailed. Significance level was set at probability (type 1 error) = 0.05. The statistical software used was SPSS, Version V27 for Windows. The study received approval from the Ethics committee in King Khalid University. Results: A total of (n = 297) Saudi elderly persons were included in the survey, of whom (n = 35, 11.8%) were men and (n = 262, 88.2%) were women. (n = 190, 64.0%) were between 65 and 74 years of age and (n = 107, 36.0%) were 75 or older. The most frequently encountered health problem was Diabetes Mellitus in (n = 126, 42.4%) followed by hypertension in (n = 117, 39.4%). (n = 117, 39.4%) reported having their urgent care needs delayed because of fear of COVID-19 infection. (n = 164, 55.2%) reported that the pandemic posed a negative effect on their mood, and further (n = 108, 36.4%) had their physical activities negatively affected. Treatment plan was impaired in (40, 13.5%) of the participants. In independent subjects (n = 24, 32.9%) were not enjoying daily activities post-pandemic, compared to (n = 63, 34.1%) who were partially dependent and (n = 7, 17.9%) who were totally dependent on others (P = 0.037). Conclusion: We surveyed a sample of elderly people in Saudi Arabia to explore their experience of interruption in healthcare services. We found 21% did not receive their medications and 39.4% had their urgent needs delayed. Physical activities, mood and enjoyment sense were all impaired. We should take into account the disruption in health services provision caused by the current COVID-19 pandemic when planning for post-pandemic geriatric healthcare.

Pharmacovigilance in Covid-19 vaccines

The ongoing pandemic coronavirus disease of 2019 (COVID-19), originated from Wuhan, China, has caused universal challenging and threatening with considerable health impact and economic losses. Therefore, vaccination, as preventive and protective medical countermeasure, remains an excellent issue for reducing morbidity and mortality of this emerging infectious disease. As of April 2021 and by Emergency Use Authorization (EUA) process, 16 vaccines were authorized by at least one national regulatory authority for public use: two Ribonucleic Acid (RNA) vaccines (Pfizer–BioNTech and Moderna), seven conventional inactivated vaccines (BBIBP-CorV manufactured by Siinopharm, CoronaVac, Covaxin, WIBP-CorV, CoviVac, Minhai-Kangtai and QazVac), five viral vector vaccines (Sputnik Light, Sputnik V, Oxford–AstraZeneca, Convidecia, and Johnson & Johnson) and two protein subunit vaccines (EpiVacCorona and RBD-Dimer). As other countries, Morocco has established an anti-COVID-19 vaccine strategy in order to effectively contribute to the monitoring of vaccine safety supported by the national platform health vigilance and regulated by the National Anti-Poison and Pharmacovigilance Center (CAPM). In this review, we recorded the main current developed COVID-19 vaccines and discussed pharmacovigilance strategies and tools related safety and tolerability of those therapies. In parallel, a review of the Moroccan experience in this field is also conducted.

Psychological, Social and Financial Impacts of COVID-19 on Clinical Practices and Academic Activities of Pakistani Ophthalmologists

Purpose: To assess the psychological, social and financial impacts of Coronavirus disease of 2019 (COVID-19) on clinical practices and academic activities of ophthalmologists throughout Pakistan.
 Study Design: Cross sectional survey.
 Place and Duration of Study: Ophthalmology Department, Sir Syed College of Medical Sciences & Hospital, Karachi.
 Methods: A self-designed survey was conducted among eye care practitioners working in various regions of Pakistan by using the online survey application named www.surveymonkey.com. The survey consisted of a 10-item questionnaire conceptualized to assess the mental health of ophthalmologists and their social and financial concerns during current COVID-19 pandemic. Data collection included the demographics details, questions assessing the psychological, financial and social influences of COVID-19 and strategies to combat the current situation.
 Results: Total of 360 valid responses were received. The individual response data was descriptively presented in frequencies and percentages without statistical analysis. Despite online facilities, 57.50% accepted that COVID has brought strain on academic activities. Eighty-eight percent ophthalmologists described decrease patient’s volume and surgeries as the main reasons of reduced income. Majority (72.50%) had closed the services due to fear of getting infected. To the solutions for reducing the viral spread, 60% favored to deal only with emergencies and vision-threatening diseases, 27.50% supported the continuity of all ophthalmic services and only 5% opted to ban the clinical work.
 Conclusion: Majority of the ophthalmologists were psychologically and financially stressed during COVID-19 and had fearful concerns regarding their clinical practices and academic activities.
 Key Words: COVID-19, Pakistan, Ophthalmologists, Clinical Practice.

The qualitative evaluation of the limitation of aerosol spread by a transparent intubation box

During the current coronavirus disease of 2019 (COVID-19) pandemic personal protective equipment (PPE) and the value of able and healthy healthcare workers (HCWs) has strongly come to the fore. In support of these efforts, as many others have done, the Department of Anaesthesiology at the University of the Free State has developed a prototype transparent intubation box in collaboration with Divine Studios. Canelli et al. effectively demonstrated the protection of HCWs from droplet contamination by the use of a similar intubation box. Feldman et al. also showed that despite the current PPE recommendations, HCWs are still contaminated on exposed skin and other areas, thus additional layers of protection may still be warranted.

Serological (Antibody-Based) Tests for COVID-19: A Pathologist's Perspective

<p>The essential and critical role of laboratory medicine in the current Coronavirus disease of 2019 (COVID19) outbreak regarding diagnosis, therapeutics and prognostics cannot be overruled. No laboratory test is perfect and there is always a dilemma especially for respiratory diseases as in case of tuberculosis. Sensitivity, specificity, PPV and NPV are not always perfect for any one test. In case of COVID-19, we need to step ahead of PCR and also start supplementary serology testing. It will provide wide range of information, important for future thinking, planning and actions against COVID-19.</p>

Initial experiences of US neurologists in practice during the COVID-19 pandemic via survey.

To test the hypothesis that US neurologists were experiencing significant challenges with lack of personal protective equipment (PPE), rapid changes in practice, and varying institutional protocols, we conducted this survey study. The current coronavirus disease of 2019 (COVID-19) pandemic has caused widespread disease and death. Rapid increases in patient volumes have exposed weaknesses in health care systems and challenged our ability to provide optimal patient care and adequate safety measures to health care workers (HCWs). A 36-item survey was distributed to neurologists around the United States through various media platforms. Over a 1-week period, 567 responses were received. Of these, 56% practiced in academia. A total of 87% had access to PPE, with 45% being asked to reuse PPE due to shortages. The pandemic caused rapid changes in practice, most notably a shift toward providing care by teleneurology, although a third experienced challenges in transitioning to this model. Wide variations were noted both in testing and in the guidance provided for the exposed, sick, or vulnerable HCWs. Notably, 59% of respondents felt that their practices were doing what they could, although 56% did not feel safe taking care of patients. Results from our survey demonstrate significant variability in preparedness and responsiveness to the COVID-19 pandemic in neurology, affected by region, health care setting, and practice model. Practice guidelines from professional societies and other national entities are needed to improve protection for physicians and their patients, promote recommended practice changes during a pandemic, and optimize future preparedness for public health emergencies.

Protecting Ourselves During the COVID-19 Pandemic

The current coronavirus disease of 2019 (COVID-19) pandemic has run rampant on our healthcare system. At the time of writing this, 3 resident physicians have died, 1 of whom was in our field.1 These young doctors had their entire careers ahead of them; they were working long hours, relying on their hospitals, their government, and their healthcare system to protect them. These residents are by no means the only victims within the healthcare system. This virus has claimed the lives of attendings, nurses, and other essential healthcare providers.