Current Coronavirus Disease Research Articles

Differences in Clinical Characteristics Between Delta Variant and Wild-Type SARS-CoV-2 Infected Patients.

Background: As delta variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevailed in the current coronavirus disease 2019 (COVID-19) pandemic, its clinical characteristics with the difference from those of wild-type strains have been little studied.Methods: We reported one cohort of 341 wild-type patients with COVID-19 admitted at Wuhan, China in 2020 and the other cohort of 336 delta variant patients with COVID-19 admitted at Yangzhou, China in 2021, with comparisons of their demographic information, medical history, clinical manifestation, and hematological data. Furthermore, within the delta variant cohort, patients with none, partial, and full vaccination were also compared to assess vaccine effectiveness.Findings: For a total of 677 patients with COVID-19 included in this study, their median age was 53.0 years [interquartile range (IQR): 38.0–66.0] and 46.8% were men. No difference was found in age, gender, and percentage of patients with the leading comorbidity between wild-type and delta variant cohorts, but delta variant cohort showed a lessened time interval between disease onset to hospitalization, a reduced portion of patients with smoking history, and a lowered frequency of clinical symptoms. For hematological parameters, most values demonstrated significant differences between wild-type and delta variant cohorts, while full vaccination rather than partial vaccination alleviated the disease condition. This reflected the viremic effect of delta variant when vaccination succeeds or fails to protect.Interpretation: Delta variant of SARS-CoV-2 may cause severe disease profiles, but timely diagnosis and full vaccination could protect patients with COVID-19 from worsened disease progression.

Can SARS-CoV-2 Infection Exacerbate Alzheimer's Disease? An Overview of Shared Risk Factors and Pathogenetic Mechanisms.

The current coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus (SARS-CoV)-2, is affecting every aspect of global society, including public healthcare systems, medical care access, and the economy. Although the respiratory tract is primarily affected by SARS-CoV-2, emerging evidence suggests that the virus may also reach the central nervous system (CNS), leading to several neurological issues. In particular, people with a diagnosis of Alzheimer’s disease (AD) are a vulnerable group at high risk of contracting COVID-19, and develop more severe forms and worse outcomes, including death. Therefore, understanding shared links between COVID-19 and AD could aid the development of therapeutic strategies against both. Herein, we reviewed common risk factors and potential pathogenetic mechanisms that might contribute to the acceleration of neurodegenerative processes in AD patients infected by SARS-CoV-2.

Medico-demographic characteristics and outcomes of COVID-19 patients admitted to a Provincial Hospital in Center-West of Morocco

The current Coronavirus Disease 2019 (COVID-19) pandemic that emerged in December 2019 in China continues to claim a thousand lives worldwide. This study aimed to report characteristics and in-hospital outcomes of a Moroccan COVID-19 cohort, and identify factors which predispose patients to hospitalization and mortality from COVID-19. We conducted a cross-sectional study of symptomatic COVID-19 patients referred to COVID-19 ward of the Settat Provincial Hospital, during October 2020. A confirmed COVID-19 case was defined by a positive detection of SARS-CoV-2 genome using real-time RT-PCR assay performed on nasopharyngeal swabs. Patients´ demographic and clinical characteristics were collected and analyzed using SPSS V22.0. Univariate followed by multivariate logistic regression analysis was performed to identify factors associated with mortality due to COVID-19. In total, 269 patients were reported. The median age was 64 years [IQR 54-73], 48.7% were elderly (≥ 65 years), 51.7% were men, and the case-fatality rate (CFR) was 5.58%. Males had a higher CFR (6.5%) than females (4.6%). In deceased people: 60% males, 73.3% were elderly, and oxygen saturation values of 90% or less on admission were more frequent (86.7%) than in recovered ones (10.9%). Most patients (80.3%) had at least one comorbidity: 100% of deaths, 59% older than 60 years, CFR was 6.94% and the most prevalent diseases were diabetes (54.6%), hypertension (41.7%), and cardiac disease (40.7%). The most common symptoms on presentation were dyspnea (67.7%), fever (65.4%) and cough (58.4%). Multivariable logistic regression analysis showed that only older age (AOR: 10.860, 95% CI: 3.382-34.86; p<0.001) and cardiac disease (AOR: 0.244, 95% CI: 0.074-0.799; p=0.02) were associated with higher mortality rates. Categorizing patients at admission according to risk factors identified by multivariate and also univariate analyses (mainly dyspnea) is essential to help in deciding the hospitalization priority and the strategy that will eventually reduce death risk.

COVID-19 Outcomes in Stage IV Cancer Patients Receiving Immune Checkpoint Inhibitors

Cancer patients are a vulnerable population in the current coronavirus disease 2019 (COVID-19) outbreak. The impact of immune checkpoint inhibitors (ICIs) on the outcomes of COVID-19 infection in cancer patients remains largely unclear. We retrospectively investigated all solid cancer patients who received at least one cycle of ICIs at a single institution between August 2020 and August 2021. All stage IV solid cancer patients who were on or ceased ICI treatment when diagnosed with COVID-19 were eligible. All COVID-19 infections were confirmed by RT-PCR. Risk factors for hospitalization, severe symptoms, and death were analyzed. A total of 56 patients were included in our study. Twenty (35.7%) patients require hospitalization, 12 (21.4%) developed severe symptoms, and 10 (17.9%) died from COVID-19 infection. ICI treatment was interrupted in 37 patients (66.1%), 24 of whom (64.9%) had treatment resumed. Eight (80%) COVID-19-related death occurred in unvaccinated individuals. Reinfection occurred in seven patients (12.5%), and three of them died from their second COVID-19 infection. Factors associated with hospitalization were high Charlson comorbidity score (OR 1.56, 95% CI 1.10–2.23, p = 0.01) and lymphocyte ≤ 1500 mm3 (OR 10.05, 95% CI 2.03–49.85, p = 0.005). Age, chemoimmunotherapy, and ICI treatment duration were not associated with increased risk of hospitalization, severe symptoms, or COVID-19-related mortality. ICI therapy does not impose an increased risk for severe COVID-19 infection in stage IV cancer patients. Vaccination should be encouraged among this population. Clinicians should be cognizant of a potential worse outcome in COVID-19-reinfected patients.

Coagulation disorders and vascular diseases of the liver in patients with COVID-19.

The current coronavirus disease 2019 (COVID-19) pandemic has caused a global health emergency crisis, since its outbreak at the end of 2019. Although it mainly affects the respiratory system, it is documented that several important extrapulmonary manifestations exist in the context of the COVID-19 infection. Amongst the major pathophysiological mechanisms, the generation of a prothrombotic environment is increasingly recognized and is related to thromboembolic events. We conducted a review of the literature and summarized the coagulation disorders in the liver in patients with COVID-19.

COVID-19 Pandemic Disruption on the Management of Tuberculosis Treatment in Indonesia.

The current coronavirus disease 2019 (COVID-19) situation might deteriorate the efforts to eliminate tuberculosis (TB) in Indonesia. This study aimed to review the COVID-19 pandemic disruption on the management of TB treatment in Indonesia. We identified several disruptions due to the pandemic on TB control management. Firstly, there is a potential decrease in the funding for TB treatment. Financial disruptions caused by the COVID-19 pandemic have led to further setbacks. In many countries, including Indonesia, financial and other resources have been reallocated from TB to the COVID-19 response. Secondly, it has been highlighted that all TB services, including case detection and rapid diagnostic, have been disrupted by the pandemic. Thirdly, the pandemic would be associated with the lower quality of care and treatment for TB in Indonesia. It might decrease the enthusiasm of patients with TB, multi-drug resistant (MDR)-TB, and TB-human immunodeficiency virus (HIV) to visit TB hospitals because of social distancing measures by the government. Finally, the COVID-19 pandemic also has impacted critical activities of monitoring, evaluation, and surveillance. There are several lessons from other countries about managing TB treatment during the pandemic, such as combining screening for COVID-19 and TB by applying x-ray technology and artificial intelligence-based software. In addition, the use of telemedicine or telehealth in TB treatment is also beneficial to deliver medication, assess patients’ progress, and inform prevention strategies. To reach the target with the end TB strategy, the government of Indonesia can adopt the World Health Organization's (WHO’s) comprehensive strategies, such as integrated, patient-centered TB care and prevention strategies; bold policies and supportive systems; and intensified research and innovations.

Pathological Features of Lung in COVID-19 Disease Subjects: A Postmortem Study

Introduction: The current Coronavirus Disease-19 (COVID-19) pandemic is considered as one of the most serious public health crises which caused more than 1.62 million deaths from October 2020 to November 2020. Acute respiratory failure is leading cause of death followed by sepsis, cardiac failure and hemorrhage. Since the pathological findings are diverse in COVID-19 and majority of studies in literature were by open autopsy; the present study was done using percutaneous core needle biopsy. Postmortem lung biopsies are rather easy and quick to perform and decrease the infective risk caused by full autopsies. This could be an essential tool for diagnosis, surveillance and research. Aim: To study the pathological features of lung in COVID-19 deceased patients by postmortem. Materials and Methods: This cross-sectional study was conducted in the Department of Pulmonary Medicine, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Vijayawada, Andhra Pradesh, India from October 2020 to November 2020. In present study, postmortem percutaneous core needle biopsies from lung were performed within two hours of death from eight deceased patients who died of COVID-19. Clinical history, inflammatory markers and treatment details were collected from case sheets, biopsy was done, specimen was collected and sent for pathological examination. Data was presented in the descriptive form for each variable. Results: Out of eight cases, five were men and three were women with a mean age of 54.12 years. Majority of patients presented with complaints of shortness of breath and fever. Hypertension, type 2 diabetes mellitus, obesity, hypothyroidism, history of pulmonary tuberculosis were the co-morbidities noticed. Four biopsies presented acute lung injury with hyaline membrane changes, Diffuse Alveolar Damage (DAD) with hyaline membrane was seen in two cases, squamous metaplasia was seen in two cases and acute lung injury with organising pneumonia was seen in two cases. Conclusion: Postmortem lung biopsies are safe, easy to perform and provide insights of possible undergoing pathology of the disease with regard to clinical presentation.

The prevalence of coronaphobia among nursing staff in Saudi Arabia.

Background:Nursing staff are in direct contact with the consequences of the current coronavirus disease 2019 (COVID-19) crisis.Design and Methods:Descriptive questionnaire-based cross-sectional survey of a sample of nursing staff working across Saudi Arabia.Results:The study included (n = 431) nursing professionals. Coronaphobia prevalence among the nursing staff was 80.3% [95% confidence interval (CI): 76.5–84%]. There were (36.7%) who had severe cornaphobia. Working in a clinical department and being Saudi national were associated with increased COVID-19 fear (estimate = 0.109, P = 0.0153 and P = 0.010, respectively).Conclusion:Hospital management in Saudi Arabia needs to acknowledge the high prevalence of coronaphobia during the current COVID-19 crisis among nursing staff.

Lessons for the future-psychosocial perspectives of vaccine literacy among beneficiaries at a COVID-19 vaccination center in a tertiary teaching hospital in Punjab, Northern India: A qualitative analysis

Background: Due to the unprecedented magnitude of the current Coronavirus disease 2019 (COVID-19) pandemic, vaccine development was fast-tracked; yet, there were barriers to vaccination uptake. Aim and Objectives: The objectives of this study were to understand the factors promoting vaccination and the barriers to vaccination, to explore the infection prevention and control practices followed after vaccination. Materials and Methods: A qualitative study using in depth interviews, both face to face and telephonic; among beneficiaries willing to participate and given at least one dose of COVID-19 vaccine in the institutions’ vaccination center, stratified sampling technique was used. Informed consent was obtained. Absolute confidentiality was ensured. The interviews were recorded and transcribed verbatim and validated by back translation into vernacular. The results obtained were analyzed using framework approach and categorized into themes and subthemes and valid conclusions drawn. Results: Various factors promoting willingness for vaccination and barriers perceived by the participants in their community, social, and occupational setting have been revealed in the present study. Availability of vaccine along with clear and accurate information can go a long way in overcoming vaccine hesitancy and promoting vaccine literacy. Conclusion: Clear and accurate information should be disseminated. The role of social media, mass media, and dissemination of information by word of mouth cannot be undermined. It is hoped that results of the present study will aid in formulating future vaccination programs.

Concealment of Allergic Reactions to Alteplase by Face Masks in Non-Communicating Acute Stroke Patients: A Warning Call to Improve Our Physical Examination Practices during the COVID-19 Pandemic.

Neurological emergencies, such as acute stroke, are especially challenging during the current Coronavirus disease-2019 (COVID-19) pandemic. Symptoms as aphasia or dysarthria are severely impacting cooperation and communication with patients. During physical examination, both the patient and the medical team are fitted routinely with surgical masks to minimize potential exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, such a practice can lead to concealment of particularly relevant physical signs. We report a case series of four acute stroke patients who were transferred for endovascular mechanical thrombectomy to our institute after intravenous thrombolysis was initiated at primary stroke centers. Upon arrival, after removing their masks, we observed oral angioedema, as a reaction to thrombolytic agent alteplase. Symptoms remained obscured by face masks through patient care at the referring stroke unit and during transportation, nevertheless they resolved after treatment. Most probably, there are a number of similar cases encountered at emergency departments and acute stroke units. To improve patient safety, a compromise between ensuring protection against the novel coronavirus and facilitating detection of potentially life-threatening physical signs must be found.

Blockchain-Enabled Federated Learning for UAV Edge Computing Network: Issues and Solutions

Unmanned aerial vehicles (UAVs) extend the traditional ground-based Internet of Things (IoT) into the air. UAV mobile edge computing (MEC) architectures have been proposed by integrating UAVs into MEC networks during the current novel coronavirus disease (COVID-19) era. UAV mobile edge computing (MEC) shares personal data with external parties (such as edge servers) during intelligent medical analytics. However, this technique raises privacy concerns about patients’ health data. More recently, the concept of federal learning (FL) has been set up to protect mobile user data privacy. Compared to traditional machine learning, federated learning requires a decentralized distribution system to enhance trust for UAVs. Blockchain technology provides a secure and reliable solution for FL settings between multiple untrusted parties with anonymous, immutable, and distributed features. Therefore, blockchain-enabled FL provides both theories and techniques to improve the performance of intelligent UAV edge computing networks from various perspectives. This survey begins by discussing the current state of research on blockchain and FL. Then, compare the leading technologies and limitations. Second, we will discuss how to integrate blockchain and FL into UAV edge computing networks and the associated challenges and solutions. Finally, we discuss the fundamental research challenges and future directions.

ORTHOPAEDIC TELEMEDICINE SERVICES DURING THE CURRENT NOVEL CORONAVIRUS PANDEMIC

ABSTRACTIntroduction To evaluate the use of telemedicine by physicians specializing in orthopaedics and traumatology at the authors’ institution, and to assess the rates of satisfaction and resolution for this type of care. The current global coronavirus disease 2019 (COVID-19) pandemic has resulted in the expansion of telemedicine services. However, quality measures and barriers for physicians dealing with the rapid increase in patients have not been well described.Materials and Methods This study included 255 patients with orthopaedic complaints. Between 24 and 48 hours after the appointment, independent physicians, who did not participate in the initial appointment, contacted one another to assess the degree of satisfaction with the appointment, and whether there was a solution to the orthopaedic complaint.Results There was a need for referral for face-to-face consultation in only 13.8% of cases. When asked about the probability of recommending telemedicine to a friend/family member, the answer was 90.3%. The satisfaction rate with the service was 91.1% and 93.69% of patients would return for a telemedicine consultation. Telemedicine consultations solved the problem in 82.74% of cases.Conclusions Telemedicine care in orthopaedics proved to be a service modality with a high rate of satisfaction among the patients evaluated. Level of evidence III, Retrospective cohort study.

As a Modulator, Multitasking Roles of SIRT1 in Respiratory Diseases

As far the current severe coronavirus disease 2019 (COVID-19), respiratory disease is still the biggest threat to human health. In addition, infectious respiratory diseases are particularly prominent. In addition to killing and clearing the infection pathogen directly, regulating the immune responses against the pathogens is also an important therapeutic modality. Sirtuins belong to NAD+-dependent class III histone deacetylases. Among 7 types of sirtuins, silent information regulator type-1 (SIRT1) played a multitasking role in modulating a wide range of physiological processes, including oxidative stress, inflammation, cell apoptosis, autophagy, antibacterial and antiviral functions. It showed a critical effect in regulating immune responses by deacetylation modification, especially through high-mobility group box 1 (HMGB1), a core molecule regulating the immune system. SIRT1 was associated with many respiratory diseases, including COVID-19 infection, bacterial pneumonia, tuberculosis, and so on. Here, we reviewed the latest research progress regarding the effects of SIRT1 on immune system in respiratory diseases. First, the structure and catalytic characteristics of SIRT1 were introduced. Next, the roles of SIRT1, and the mechanisms underlying the immune regulatory effect through HMGB1, as well as the specific activators/inhibitors of SIRT1, were elaborated. Finally, the multitasking roles of SIRT1 in several respiratory diseases were discussed separately. Taken together, this review implied that SIRT1 could serve as a promising specific therapeutic target for the treatment of respiratory diseases.

Should I stay or should I go? Observation post-vaccination during the COVID-19 pandemic and the law of unintended consequences.

Standard practice after all vaccinations in Australia is to observe patients for 15min. During the coronavirus disease 2019 (COVID-19) pandemic, could the risk of contracting and dying from COVID-19 acquired in the waiting room be greater than the risk of dying from post-vaccine anaphylaxis when leaving immediately? The risks are modelled for a patient aged 70+years attending for annual influenza vaccination in a typical Australian general practice clinic. The risk of death from anaphylaxis is estimated based on known rates of anaphylaxis shortly after influenza vaccination. The risk of acquiring COVID-19 during a 15-min wait and then dying from that infection is estimated using the COVID-19 Aerosol Transmission Estimator and COVID-19 Risk Calculator. Other than at times of extremely low COVID-19 prevalence, the risk of death from anaphylaxis for a patient aged 70+years leaving immediately after influenza vaccine is less than the risk of death from COVID-19 acquired via aerosol transmission during a 15-min wait. The risk of death from COVID-19 is greatest for the unimmunised and when masks are not worn. A more nuanced approach to advice post-vaccination is recommended that considers current COVID-19 prevalence and virulence, the characteristics of the waiting room, the risk of anaphylaxis, and the patient's susceptibility to death from COVID-19. There are many circumstances where it would be safer for a patient to leave immediately after vaccination.

Realities and Challenges of Healthcare Workers in Kosovo during COVID-19: An Overview in Healthcare Workers

Introduction: Healthcare workers across the world have been raised to the demands of treating COVID-19 patients, potentially at significant cost to their own health and wellbeing. The coronavirus disease 2019 (COVID-19) pandemic has caused an increasing of challenges for healthcare professionals not only in Kosovo but globally. However, the psychological impact and change behavior, of the coronavirus disease 2019 pandemic, among healthcare workers, are still unknown. Aim: The purpose of this paper is to know the reality and challenges of healthcare workers in Kosovo during the current COVID-19 outbreak. Methodology: This is a cross-sectional, online survey which was conducted from 15 March 2020 to 30 July 2020 on 309 healthcare workers at three hospitals in Kosovo. An online survey questionnaire was used to collect data on participants’ characteristics, questions about gel hand sanitizer, disposable gloves, masks, facial protective shields, including questions such as: Do they have any chronic disease? Do they have fear from infection? Were they getting information about COVID-19? Do they have a stress during their work? Do they carry about public health measures and policies? The study protocol was approved by the ethical commission of our university. Findings: A total of 309 healthcare workers and medical practices completed the online survey. Most participants were female (n = 233; 75.4%), and live in city (n = 174; 56.3%). Based on their income (n = 250; 80.9%), by having a middle income and (n = 44; 14.2%) low income. Regarding provide services to people with COVID-19, 69.3% of participants were directly with infected patients, and during this time those who were worried to get infected with coronavirus were 31.4%, who said that they were afraid of becoming infected. The frustration was that if they become infected, the possibility of transmitting the virus to other family members will increase, where 35% stated that they are very scared and extremely scared 21.4%. Conclusion: Our study highlighted the importance of taking into consideration the experiences and concerns on front-line staff during pandemic. Factors such as older age, being female, chronic diseases and trainings may protect healthcare workers from fear during pandemic.

Anti-Coronavirus Vaccines: Past Investigations on SARS-CoV-1 and MERS-CoV, the Approved Vaccines from BioNTech/Pfizer, Moderna, Oxford/AstraZeneca and others under Development Against SARSCoV- 2 Infection.

The aim of this review article is to summarize the knowledge available to date on prophylaxis achievements in the frame of the fight against Coronaviruses. This work will give an overview of what is reported in the recent literature on vaccines (under investigation or already developed like BNT162b2, mRNA-1273, and ChAdOx1-S) effective against the most pathogenic Coronaviruses (SARS-CoV-1, MERS-CoV-1, and SARS-CoV-2), with of course particular attention paid to those under development or already in use to combat the current COVID-19 (CoronaVIrus Disease 19) pandemic. Our main objective is to make a contribution to the comprehension, even at a molecular level, of what is currently ready for anti-SARS-CoV-2 prophylactic intervention, as well as to provide the reader with an overall picture of the most innovative approaches for the development of vaccines that could be of general utility in the fight against the most pathogenic Coronaviruses.

Development and implementation of the National Heart, Lung, and Blood Institute COVID-19 common data elements.

Coronavirus Disease 2019 (COVID-19) instigated a flurry of clinical research activity. The unprecedented pace with which trials were launched left an early void in data standardization, limiting the potential for subsequent data pooling. To facilitate data standardization across emerging studies, the National Heart, Lung, and Blood Institute (NHLBI) charged two groups with harmonizing data collection, and these groups collaborated to create a concise set of COVID-19 Common Data Elements (CDEs) for clinical research. Our iterative approach followed three guiding principles: 1) draw from existing multi-center COVID-19 clinical trials as precedents, 2) incorporate existing data elements and data standards whenever possible, and 3) alignment to data standards that facilitate data sharing and regulatory submission. We also supported rapid implementation of the CDEs in NHLBI-funded studies and iteratively refined the CDEs based on feedback from those study teams. The NHLBI COVID-19 CDEs are publicly available and being used for current COVID-19 clinical trials. CDEs are organized into domains, and each data element is classified within a three-tiered prioritization system. The CDE manual is hosted publicly at https://nhlbi-connects.org/common_data_elements with an accompanying data dictionary and implementation guidance. The NHLBI COVID-19 CDEs are designed to aid data harmonization across studies to achieve the benefits of pooled analyses. We found that organizing CDE development around our three guiding principles focused our efforts and allowed us to adapt as COVID-19 knowledge advanced. As these CDEs continue to evolve, they could be generalized for use in other acute respiratory illnesses.

Psychological effect of the COVID-19 pandemic on a cohort of Egyptian population

Background The current coronavirus disease (COVID-19) pandemic has had a great effect worldwide. Although health care workers (HCWs) play an essential role and are one of the most exposed groups, information about the psychosocial effect among the general population and those who came in contact with COVID-19-infected patients is still required.Aim The study’s main aim was to assess the prevalence of anxiety and depression among the general population, those who came in contact with patients, and frontline HCWs in response to the COVID-19 pandemic in Egypt and to investigate factors associated with psychological distress.Materials and methods A cross-sectional study was carried out using an online-administered questionnaire. The questionnaire included sociodemographic data and data related to the current pandemic. Hospital-based anxiety and depression scale (HADS)-Arabic version was used to assess anxiety and depression. Multivariable logistic regression analysis was performed to identify significant predictors.Results A total of 1778 participants were involved in the current study, and of them, 82.6% were general population, 10.6% were HCWs, whereas those who came in contact with COVID-19-infected patients were 6.8%, with more female predominance. Of 1778 participants, 711 (40%) had abnormal depressive score. Overall, 52.9% of those who came in contact with COVID-19-infected patients had abnormal depressive score, whereas 39.4% and 36.5% of the general population and HCWs, respectively, had abnormal depressive score, with statistically significant difference. Regarding anxiety, there was a highly significant difference among the three groups with higher abnormal anxiety score among those who came in contact with COVID-19-infected patients (46.3%) than the general population and HCWs (33% and 33.9%, respectively). Overall, 34% of all participants had abnormal anxiety score. While evaluating different parameters associated with psychological distress by multiple logistic regression analysis, individuals without a history of previous psychological illness and those who rely on internet and approved sites as sources of information experienced less anxiety and depression. Female sex and lower levels of education have a higher risk of anxiety.Conclusions During the current pandemic, the Egyptian population has a high prevalence of psychological distress, with a higher prevalence among those who came in contact with COVID-19-infected patients than in the general population and HCWs. Among different parameters associated with psychological distress, individuals without a history of previous psychological illness and those who rely on internet and approved sites as sources of information experienced less anxiety and depression during the COVID-19 pandemic. Therefore, establishing early targeted mental health interventions should become routine as a part of our preparedness efforts.

Dysglycemia in ICU Patients

AbstractDysglycemia has emerged as a very common challenge in critically ill patients, especially with regard to current coronavirus disease 2019 pandemic. Prediabetes, poorly controlled diabetes, pharmaceutical intervention in intensive care unit (ICU) with glucocorticoids, catecholamines and other medicines, and stress response all contribute to dysglycemia in critically ill patients. Early identification and management are the key to prevent further complications. Patient prognosis in terms of clinical outcome, length of ICU stay, and in-hospital morbidity/mortality are adversely affected by patient's dysglycemic status. Apart from hyperglycemia, the other three important pillars of dysglycemia are discussed in this article. Synopsis of early intervention have been captured from India-specific practice guidelines. Important landmark trials have also been captured in this article to provide a clarity on certain aspects of managing dysglycemia in ICUs. Hence, this review article is an attempt to bring forth the salient aspects in diagnosing and managing dysglycemia in critical care settings.

A bibliometric analysis on global eHealth.

BackgroundThe current coronavirus disease 2019 pandemic highlights the potential of eHealth. Drawing the knowledge map of eHealth research through data mining and visual analysis technology was helpful to systematically present the research status and future trends of global academic circles.MethodsBased on the web of Science Core Collection (SCIE/SSCI) database, using bibliometric theory and visual analysis technology, this work analyzed the global eHealth research publications from 2000 to 2021, and introduced the interdisciplinary characteristics, hot topics and future trends in this field.ResultsA total of 10188 authors, 891 journals, 3586 institutions, 98 countries using 12 languages had conducted eHealth research in the world. The United States, the Netherlands, Australia and the United Kingdom were the main forces and international cooperation. However, the international co-operation between Eastern and Western countries was still relatively few. The frontier of global eHealth research mainly focused on #0eHealth innovation, #1physical activity, #2generalised anxiety disorder, #3lightweight authentication protocol, #4 eHealth information, #5technology readiness, #6 ehealth literacy scale, #7family carer, #8citance analysis, #9 guiding patient. Clusters #3 lightweight authentication protocol and #9 guiding patient were the latest clusters, indicating the research trend and direction of eHealth in the future.ConclusionsCooperation network framework at the regional, national and global levels and the cooperation of multidisciplinary teams with complementary backgrounds and expertise were needed to realize the in-depth popularization and application of eHealth knowledge. Interdisciplinary international cooperation should be the trend of eHealth research in the future.