End Of First Wave Research Articles

Bleeding and thrombotic events and intensity of heparin therapy in the two first waves of COVID-19.

A systemic inflammatory response occurs during SARS-CoV2 infection and is associated with hypercoagulability and thrombotic events. From March 2020 in our hospital different dosages of low-molecular weight heparin (LMWH) were introduced according to the level of patient care intensity. Because bleeding episodes occurred in hospitalized COVID-19 patients on heparin, the dosage of LMWH at the end of first wave was tailored on the severity of COVID-19. The aim of this study is to describe bleeding and thrombotic events in patients hospitalized with SARS-CoV2 infection on LMWH therapy in the two waves of COVID-19 and analyze the factors associated with these events. Among 1143 patients enrolled in the COVID-19 Network registry, 912 were included in the analysis, 537 of them admitted during the first wave and 375 during the second. Bleeding events were 30 (3.3%): 22 (2.4%) major and 8 (0.9%) non-major. Arterial and venous thrombotic events were 6 (0.7%) and 24 (2.6%). The incidence of venous thrombotic events was higher in the first than in the second wave (0.29% [95% CI 0.20-0.45] events/day vs. 0.05% [95% CI 0.02-0.16]), with a 71% risk reduction (95% CI 22%-94%). The incidence of bleeding was 0.33% (95% CI 0.22-0.50) vs 0.14% events/day (95% CI 0.07-0.28), with no statistical between-wave difference (HR 0.41 95% CI 0.16-1.08). After adjusting for the competing risks of death and comorbidities, patients in the second wave had lower odds to have thrombotic events than in the first wave (0.24 HR [95% C.I. 0.07-0.89]). In this retrospective study on COVID-19 we found a low rate of hemorrhagic and thrombotic events, that may be explained by the absence in the case material of patients admitted to intensive care unit.

Psychological Status of Nepalese Young Adults During The End of First Wave of COVID-19 Pandemic.

Psychological problems increased during the period of COVID-19. Lockdown" is adopted in many countries of the world. It has also been seen that COVID-19 has led not only to an increase of infection and death but also vast change in the lifestyles of every individual especially in young adults causing various mental health issues. However, in Nepal, there are limited studies to address this issue. The main objective of this study is to generate evidence on the prevalence of symptoms of post-traumatic stress disorder, anxiety, and depression among young adults and the factors contributing to these outcomes in Nepal. Cross-sectional methods were employed using an online structured questionnaire in January 2021, among 1229 participants. Three logistic regression models were performed to examine the significant COVID-19 factors. The prevalence of Depression, Anxiety and post-traumatic stress disorder related symptoms in this study were 255(20.4%), 240(19.2%)and 162(13.2%) respectively relate.COVID-19 diagnosis, COVID-related stress and exposure was significantly related to depression. Similarly, COVID-19 diagnosis, change in income during COVID-19, being exposed to 4 or more exposure factors had high chances of getting anxiety. Also, income change during COVID-19 and stressors during COVID-19 were related to post-traumatic stress disorder. This research shows that various COVID-19 related factors have contributed to the high prevalence of these outcomes.

Second Versus First Wave of COVID-19 in Patients with MPN

Second Versus First Wave of COVID-19 in Patients with MPN

Case study of COVID 19 from August to end of December 2020 in Babylon, Iraq

Objectives: The aim of study is to study Case study of COVID 19 in Babylon Province in Iraq. Method: In January 2021 we started searching for the official source for the numbers of people infected with COVID19 within the borders of Babylon Governorate, where the Babylon Health Department was reviewed, and after that we were directed with official authorization to the Public Health Department in Babylon Governorate / Department of Communicable Diseases / Respiratory Diseases Unit (weekly periodic visit). Where the official numbers were obtained for the number of infected people and the number of deaths that occur due to complication with this infection, as well as the number of recovery cases from the date of 01/08/2020 to 01/01/2021. Results: related to the number of infected cases we see decrease the no. of infected with corona virus in Babylon Governorate from beginning the study to become lest at the end of 2020 with the significant decrease (P < 0.05) (The highest infected cases were notices in first month (1/8 – 31/8) while the lowest cases were seen in last month (1/12 – 31/12)) that may be due to: The main cause may be the most people may have gained herd immunity or population immunity, is the indirect protection from an infectious disease that happens when a population is have immunity developed through previous infection, that may refer to the end of first wave of this pandemic which start from the June. Conclusion: Knowing the pathogenesis of the virus and risk factors, increasing the experience of doctors and working cadres, increasing clinical capacity, providing specialized treatments, increasing the number of ICU beds, in addition to increasing the number of respiratory ventilators and increasing the number of tests.

SARS-CoV-2 antibody seroprevalence after the first wave among workers at a community healthcare system in the Greater Boston area

ABSTRACT SARS-CoV-2 antibody seroprevalence among health-care workers (HCW) can assess past exposure and possible immunity, which varies across different regions, populations and times. We investigated the seroprevalence among HCW in Massachusetts (a region suffering high COVID-19 mortality) at the end of first wave of the SARS-CoV-2 pandemic. All HCW at Cambridge Health Alliance were invited to participate in this cross-sectional survey in June 2020. Those who volunteered, consented and provided a blood sample were included. Dried blood specimens from finger-prick sampling collected either at home by each HCW or onsite by the study team were analyzed for anti-SARS-CoV-2 IgM and IgG to the virus’ receptor binding domain, using an enzyme-linked immunosorbent assay. IgM and IgG antibody abundance were categorized based on the number of standard deviations above the cross-reacting levels found in existing, pre-pandemic blood samples previously obtained by the Ragon Institute and analyzed by the Broad Institute (Cambridge, MA). Seroprevalence estimates were made based on ‘positive’ IgM or IgG using ‘low’ (>6 SD), ‘medium’ (>4.5 SD), and ‘high’ prevalence cutoffs (>3 SD). A total of 433 out of 5,204 eligible HCWs consented and provided samples. Participating HCWs had a lower cumulative incidence (from the start of the pandemic up to the bloodspot collections) of SARS-CoV-2 RT-PCR positivity (1.85%) compared to non-participants (3.29%). The low, medium, and high seroprevalence estimates were 8.1%, 11.3%, and 14.5%, respectively. The weighted estimates based on past PCR positivity were 13.9%, 19.4%, and 24.9%, respectively, for the entire healthcare system population after accounting for participation bias.

Modeling COVID-19 pandemic using Bayesian analysis with application to Slovene data

In the paper, we propose a semiparametric framework for modeling the COVID-19 pandemic. The stochastic part of the framework is based on Bayesian inference. The model is informed by the actual COVID-19 data and the current epidemiological findings about the disease.The framework combines many available data sources (number of positive cases, number of patients in hospitals and in intensive care, etc.) to make outputs as accurate as possible and incorporates the times of non-pharmaceutical governmental interventions which were adopted worldwide to slow-down the pandemic. The model estimates the reproduction number of SARS-CoV-2, the number of infected individuals and the number of patients in different disease progression states in time. It can be used for estimating current infection fatality rate, proportion of individuals not detected and short term forecasting of important indicators for monitoring the state of the healthcare system. With the prediction of the number of patients in hospitals and intensive care units, policy makers could make data driven decisions to potentially avoid overloading the capacities of the healthcare system. The model is applied to Slovene COVID-19 data showing the effectiveness of the adopted interventions for controlling the epidemic by reducing the reproduction number of SARS-CoV-2. It is estimated that the proportion of infected people in Slovenia was among the lowest in Europe (0.350%, 90% CI [0.245–0.573]%), that infection fatality rate in Slovenia until the end of first wave was 1.56% (90% CI [0.94–2.21]%) and the proportion of unidentified cases was 88% (90% CI [83–93]%).The proposed framework can be extended to more countries/regions, thus allowing for comparison between them. One such modification is exhibited on data for Slovene hospitals.

Prophylactic effects of vitamin E and selenium on di(n-butyl) phthalate-induced testicular damage in prepubertal rats

Di (n-butyl) phthalate (DBP), a potential endocrine disruptor, adversely affects male reproductive function via activation of oxidative stress. This study was conducted to investigate the protective effects of vitamin E (Vit E) and selenium (Se) on DBP-induced testicular damage. Prepubertal rats were given 500 mg DBP/kg alone and in combination with Vit E (250 mg/kg) & Se (1 mg/kg) by oral gavage for 7 days and sacrificed at day 1 (D1), D30 and D45 after administration. Testicular section of DBP-treated rats showed markedly distorted seminiferous tubules, no spermatids and a reduction in the thickness of their epithelial lining, compared to the control. In contrast, co-administration of Vit E & Se protected the seminiferous tubules and regained its normal architecture to the control level. To clarify whether spermatogenic cells differentiate into mature spermatids in the treated testes at the end of first wave of spermatogenesis, immunostaining for Hsc 70t, a specific marker for spermatids, was carried out. As a result, the increase in maturation of spermatids in Vit E & Se+DBP-treated testes, compared to the DBP-treated, was demonstrated. For example, the most advanced spermatids in the tubules from rats in the DBP-treated groups were steps 8-9 at D45 of recovery, while those of the DBP+Vit E & Se-treated were steps 14-19 that were more or less similar to the control group. These results show for the first time that prepubertal administration of Vit E & Se have protective effects on DBP-induced testicular damage and restoration of normal spermatogenesis.