Coronavirus Disease 2019 Experience Research Articles

Adequate serum 25-hydroxy-vitamin D levels are correlated with low anti-PF4 levels in mild COVID-19 Patients: An observational study.

The worldwide spread of coronavirus disease 2019 (COVID-19) has resulted in an unparalleled health emergency of global proportions. Around 31% of individuals with COVID-19 experience thrombosis associated with hypercoagulation. COVID-19 patients have shown an increase in platelet activation, but the mechanism has not been fully understood yet. One theory suggests that this could be related to the heparin-induced thrombocytopenia phenomenon, where platelet activation involves anti-PF4 antibodies that are associated with thrombosis. Vitamin D has been established to exert an influence on immunological responses and inflammation. The aim of this study is to analyze the correlation between serum 25-hydroxy-cholecalciferol [25(OH)D] levels and anti-PF4 antibodies among COVID-19 patients. A cross-sectional study was conducted among 160 COVID-19 patients at Cipto Mangunkusumo General Hospital and Wisma Atlit Hospital Jakarta from October 2021 to January 2022. The mean serum 25(OH)D level was 15.1 ng/mL. A significant negative correlation was found between serum 25(OH)D and anti-PF4 levels in mild COVID-19 patients (P = .035; R = -0.236). Remarkably, P-selectin levels were significantly higher in the moderate COVID-19 group compared to the severe group (P = .031). Serum 25(OH)D level had a significant negative correlation with anti-PF4 level in mild COVID-19 patients. Thus, it is highly recommended to ensure that serum 25(OH)D levels are maintained above 30 ng/mL. Remarkably, the P-selectin level was significantly higher in the moderate COVID-19 group compared to the severe group.

The impact of the COVID-19 pandemic on the academic achievement of elementary and junior high school students: analysis using administrative data from Amagasaki City

AbstractThe coronavirus disease 2019 (COVID-19) pandemic has had a global impact on children’s education. In Amagasaki City, Japan, elementary and junior high schools were temporarily closed for approximately three months during the pandemic. This study examines the effects of the COVID-19 pandemic on academic performance in mathematics and the Japanese language among public elementary and junior high school students in Grades 1 to 8. Using data from the Amagasaki City Survey of Academic Achievement and Life Conditions from 2018 to 2021, this study compares changes in the academic performance of cohorts with and without COVID-19 experience (the COVID-19 and non-COVID-19 cohorts, respectively) 7 and 19 months after school closures using the difference-in-differences method. The findings indicate that the negative impact of the pandemic on academic performance was more pronounced for math than for the Japanese language, both at 7 months and 19 months after the closures. Math scores showed considerable decreases of 0.133 standard deviations (SDs) and 0.249 SDs at 7 and 19 months after the closures, respectively, while Japanese language scores were not significantly affected 7 months after closures but decreased by 0.113 SDs at 19 months after the closures. Furthermore, the negative effects on Japanese language scores were more significant for individuals in younger grades, whereas math scores were consistently affected across all grades. These results have important implications for policymakers and educators struggling to overcome the learning losses among children caused by the pandemic.

Association between the COVID-19 pandemic and childhood development aged 30 to 36 months in South Korea, based on the National health screening program for infants and children database

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on the neurodevelopment of children. However, the precise effects of the virus and the social consequences of the pandemic on pediatric neurodevelopment are not yet fully understood. We aimed to compare the neurodevelopment of children between before and during the COVID-19 pandemic, as well as examine the impact of socioeconomic status (SES) and regional differences on the development.MethodsThe study used the Korean Developmental Screening Test to compare the difference in the risk of neurodevelopmental delay between before and during the COVID-19 pandemic. Multivariable logistic regression analysis was conducted to identify the relationship between experiencing the COVID-19 pandemic and the risk of neurodevelopmental delay. Stratified analyses were performed to determine whether the developmental delays caused by the pandemic’s impact varied depending on SES or regional inequality.ResultsThis study found an association between the experience of COVID-19 and a higher risk of neurodevelopmental delay in communication (adjusted OR [aOR]: 1.21, 95% confidence interval [CI]: 1.19, 1.22; P-value: < 0.0001) and social interaction (aOR: 1.15, 95% CI: 1.13, 1.17; P-value: < 0.0001) domains among children of 30–36 months’ ages. Notably, the observed association in the Medicaid group of children indicates a higher risk of neurodevelopmental delay compared to those in the non-Medicaid group.ConclusionsThese findings highlight the need to be concerned about the neurodevelopment of children who experienced the COVID-19 pandemic. The study also calls for increased training and support for Medicaid children, parents, teachers, and healthcare practitioners. Additionally, policy programs focused on groups vulnerable to developmental delays are required.

COVID-19 experience of people with severe mental health conditions and families in South Africa.

People with severe mental health conditions, such as schizophrenia, and their family caregivers are underserved in low- and middle-income countries where structured psychosocial support in the community is often lacking. This can present challenges to recovery and for coping with additional strains, such as a pandemic. This study explored the experiences and coping strategies of people with lived experience of a severe mental health condition, and family caregivers, in South Africa during the initial stages of the coronavirus disease 2019 (COVID-19) pandemic. This qualitative study was conducted in the Nelson Mandela Bay District, Eastern Cape, South Africa, in the most restrictive period of the COVID-19 lockdown. Telephonic qualitative interviews were conducted with people with lived experience (n = 14) and caregivers (n = 15). Audio recordings were transcribed and translated to English from isiXhosa. Thematic analysis was conducted with NVivo 12. Participants described negative impacts including increased material hardship, intensified social isolation and heightened anxiety, particularly among caregivers who had multiple caregiving responsibilities. Coping strategies included finding ways to not only get support from others but also give support, engaging in productive activities and taking care of physical health. The main limitation was inclusion only of people with access to a telephone. Support needs for people with severe mental health conditions and their families should include opportunities for social interaction and sharing coping strategies as well as bolstering financial security. These findings indicate that current support for this vulnerable group is inadequate, and resource allocation for implementation of additional community-based, recovery-focused services for families must be prioritised.

Mental health outcomes and their influencing factors on patients with COVID-19 in the Fangcang shelter hospital in China.

Coronavirus disease 2019 (COVID-19) affects physical and mental health of patients. This study aimed to investigate the psychological distress, level of hope, and the role of families of patients with COVID-19 in the Fangcang shelter hospital (FSH) and explore potential influencing factors. We conducted an online observational cross-sectional study on 397 patients with mild to moderate COVID-19 from two FSH in Shanghai, China from 12 April to 16 May 2022. The questionnaire included demographic information, distress thermometer (DT), family adaptation, partnership, growth, affection, resolve (APGAR) index, and the Herth hope index (HHI). The patients reported symptoms of severe psychological distress (n = 109, 27.46%) and low levels of family care (n = 152, 38.29%). More than half of the patients (n = 244, 61.46%) exhibited high levels of hope, and around one-third of the patients (n = 151, 38.04%) reported moderate levels of hope. The study noted a significant negative correlation between the scores for psychological distress and APGAR and a significant positive correlation between the scores for APGAR and HHI (p < 0.05). The FSH living experience, diet, and symptoms of COVID-19 were closely associated with psychological distress among patients (p < 0.05). Patients with COVID-19 living in the FSH reported high levels of symptoms of psychological distress and low levels of family care, but relatively high levels of hope. Health care workers should improve the living and eating conditions in the FSH, strengthen family support, and alleviate the COVID-19 related symptoms of patients.

Colorectal cancer treatment outcomes during the pandemic: Our experience of COVID-19 at a tertiary referral center.

The coronavirus disease 2019 (COVID-19) has led to major shifts in the management of colorectal cancer (CRC). This study aims to identify the impact and early outcomes of COVID-19 following CRC management at a tertiary referral center in Victoria, Australia. This was a retrospective study, utilizing the Australian Comprehensive Cancer Outcomes and Research Database and inpatient records. Patients presenting for CRC management at our institution were identified coinciding with the first Victorian outbreak of COVID-19 (March 26 to September 26, 2020) (COVID). Management decisions including chemoradiotherapy utilization and surgical outcomes were analyzed within 6 months and compared with the corresponding period in 2019 (pre-COVID). A total of 276 patients were included in this study (147 pre-COVID period, 129 COVID period). During the COVID period, more patients (47.6% vs. 60.5%; p=0.033) presented symptomatically and less for surveillance (10.9% vs. 2.3%; p<0.01). Eighty-four pre-COVID and 69 COVID period patients proceeded to surgery. The average time from diagnosis date to surgery was 15.6 days less during the COVID period. There were no significant differences in postoperative utilization of higher care (p=0.74), complications (p=0.93), median hospital length of stay (p=0.67), 30-day readmission (p=0.50), or 30-day reoperation (p=0.74). In 1.6% of cases, pandemic impacts resulted in a change in management. Presentation of patients with CRC varied, with a significant increase in symptomatic presentations and decreased numbers for surveillance. Through flexibility and change in practice, our institution helped improve access to surgical intervention and oncological therapies. Further prospective work is required to identify long-term outcomes and characterize the effects of ongoing disruptions.

The Impact of Comprehensive Rehabilitation on the Exercise Capacity of Patients after COVID-19.

Coronavirus Disease 2019 (COVID-19) is a complex disease that affects multiple body systems, including the respiratory, cardiovascular, neurological, and muscular systems. It is estimated that approximately half of the patients after the treatment for COVID-19 experience persistent symptoms that lead to a decreased physical capacity. Scientific recommendations suggest that cardiovascular and respiratory rehabilitation programs should be implemented in patients who have completed treatment for COVID-19. Therefore, the objective of this study was to evaluate the impact of comprehensive rehabilitation on the exercise capacity of patients after COVID-19 treatment. The study included 146 patients after the treatment for COVID-19 who were eligible for therapeutic rehabilitation. The exercise capacity was assessed using the 6-minute walk test (6MWT). The results showed that patients who underwent rehabilitation had an average increase of 23.83% in their 6MWT score compared to the baseline. A comprehensive rehabilitation program including breathing exercises, aerobic training, and strength and endurance exercises is an effective intervention that can improve the physical capacity of patients after COVID-19 treatment.

The unique COVID-19 experience in Western Australia: lessons learnt.

Western Australia (WA) was in a unique position to experience coronavirus disease 2019 (COVID-19) in a highly vaccinated and geographically isolated population. To describe the COVID-19 Omicron experience at the only quaternary hospital in WA following border opening from 3 March to 11 May 2022. A total of 158 adults with microbiologically confirmed COVID-19 were admitted to the respiratory or intensive care unit (ICU). Admission numbers, disease severity, prevalence of COVID-19 deterioration risk factors, immunisation status, severity of infection, immunosuppression and treatment regimen. One hundred fifty-eight COVID-19-positive patients were admitted to the respiratory ward (n = 123) and the ICU (n = 35) during the study period. COVID-19 infection was the primary admission reason in 32.9% of patients, 51.3% were male and the median age was 62 years. Aboriginal or Torres Strait Islanders (ATSI) were overrepresented (13.3%). Care was predominantly ward based (77.2%). Nearly half of the patients had mild COVID-19 (49.4%). Dexamethasone was the most common treatment provided to patients (58.2%). The median length of stay was 5.8 days (interquartile range, 5-15). Eight patients died during the study period (5.1%), with three of those deaths attributable to COVID-19. COVID-19 case numbers following WA state border opening were of lower care acuity and disease severity than predicted. Two-thirds of admissions were for other primary diagnoses, with incidental COVID detection. Hospital admissions were overrepresented by partially or unvaccinated patients and by ATSI Australians. An increase insocial support along with general and geriatric medicine speciality input were required to treat hospitalised COVID-19 cases in the WA Omicron wave.

Hematomyelia associated with coronavirus disease 2019: A rare case report.

Coronavirus disease 2019 (COVID-19) can damage the central nervous system. Although there have been reports of cerebral hemorrhage and infarction caused by COVID-19, hematomyelia due to COVID-19 has never been reported. A 40-year-old male was admitted to the hospital with positive nucleic acid detection for COVID-19 after experiencing fever for 2 weeks, urinary retention, fecal retention, and pain in both lower extremities for a week. The patient diagnosis was established using thoracic and lumbar magnetic resonance imaging (MRI). Contrast-enhanced thoracic and lumbar MRI revealed subdural (dorsal predominant) short T1 and slightly long T2 bands in the T12-S2 infundibular canal in the scan field, and the subdural hematoma was yet to be distinguished from other diseases. Spinal cord edema was observed in the left vertebral plate and facet joint of the T11 vertebral body, indicative of inflammation. The cerebrospinal fluid (CSF) was positive for COVID-19 nucleic acid. Antiinfection, immunomodulation, correction of acid-base balance and electrolyte disorders, improvement of circulation, nerve nutrition, and other symptomatic supportive treatments were administered to the patient. The patient symptoms significantly improved after 4 weeks of anti-infection and immunomodulatory therapy. Repeat thoracolumbar MRI revealed absorption of the spinal cord hematoma, and the patient was discharged from the hospital. To date, COVID-19-related hematomyelia has not been reported and anti-infective and immunomodulatory therapies may be effective. COVID-19 not only easily leads to brain injury but can also cause spinal cord injury and even spinal cord hemorrhage. When patients with COVID-19 experience symptoms and signs of spinal cord injury, spinal cord injury and bleeding caused by COVID-19 should be considered, and MRI and lumbar puncture should be performed as soon as possible to make a clear diagnosis.

AN OBSERVATIONAL STUDY OF PRACTICE OF COVID-19 VACCINATION AMONG HEALTHCARE WORKERS AT A TERTIARY HEALTHCARE CENTRE: A SURVEY BASED ANALYSIS.

Background: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The rapid and extensive spread of the COVID-19 pandemic has become a major cause of concern for the healthcare profession. Development of SARS-CoV-2 vaccine is considered as the only way to signicantly reduce the threat of this pandemic in view of no proper treatment available against COVID-19 till date. However, the success of COVID-19 vaccination in India is dependent upon the acceptance of vaccine among general population, besides the proven safety and efcacy of the Indian COVID-19 vaccines (Co vishield and Co vaxin). In view of that, we conducted an online survey among the rst to be vaccinated priority group (healthcare workers) in India who are at high risk of exposure, with the aim to assess the beliefs and experiences related to Indian COVID-19 vaccines and to project that upon the general population of India. Method: This cross sectional study was conducted using a validated self administered online questionnaire that was distributed through emails, online social networking platforms (online survey) and also printed form of questionnaire in both English and Hindi languages (paper survey). The participants of the study were informed about the objectives of the study and after obtaining an informed consent, they completed the questionnaire on their background and vaccinationbehaviour related variables (including past vaccine compliance, risk factors for severe COVID-19, and COVID-19 vaccine perceptions and experience). Results: Our study included 750 healthcare workers (HCW) of which 415 were doctors, 286 were medical students and 49 were paramedical staff, Of the total number of participants, n=617 (82.3%) have received the COVID-19 vaccine. 75.6% of the study population (n=504) were not hesitant for getting vaccination against COVID-19. Majority of the HCWs believed in the safety and efcacy of COVID-19 vaccine and wanted their family members to get vaccinated. Conclusions: Our study concludes that Health Care Workers show acceptance and condence in the vaccination programme against Covid 19. This can contribute to general population compliance and willingness to accept Covid 19 vaccine.

Clinical trial experience in Japan and future issues in developing drugs to treat COVID-19.

The National Center for Global Health and Medicine plays a central role in the treatment and research of infectious diseases in Japan. It has conducted various research and development activities on drugs to treat coronavirus disease 2019 (COVID-19) with clinical questions as starting points. Clinical trials are essential in developing new treatment modalities, but we have noticed some characteristic difficulties in clinical trials on emerging and re-emerging infectious diseases. For example, since there is no standard of care when an emerging infectious disease starts to spread, establishing an appropriate control group is complicated, and many things are hurried at the start of trials. This means there is little time to arrange a placebo, and conducting blinded, randomized, controlled trials has been difficult. Another issue characteristic of infectious disease has been that progress in enrolling subjects is affected by the spread of the disease. It was also a struggle to select institutions that provide medical care on the front lines of infectious disease and conduct clinical trials regularly. To start multicenter clinical trials expeditiously, a regulated and structured network is thus considered necessary. From the perspective of implementation, it is preferable to conduct decentralized clinical trials (DCTs) that do not depend on people coming to the medical institution, while from the perspective of preventing infections during the spread of COVID-19, wide adoption of eConsent is desirable. Based on the experience of COVID-19, new measures must be taken to prepare for emerging and re-emerging infectious diseases in the future.

Erythrocytes Functionality in SARS-CoV-2 Infection: Potential Link with Alzheimer's Disease.

Coronavirus disease 2019 (COVID-19) is a rapidly spreading acute respiratory infection caused by SARS-CoV-2. The pathogenesis of the disease remains unclear. Recently, several hypotheses have emerged to explain the mechanism of interaction between SARS-CoV-2 and erythrocytes, and its negative effect on the oxygen-transport function that depends on erythrocyte metabolism, which is responsible for hemoglobin-oxygen affinity (Hb-O2 affinity). In clinical settings, the modulators of the Hb-O2 affinity are not currently measured to assess tissue oxygenation, thereby providing inadequate evaluation of erythrocyte dysfunction in the integrated oxygen-transport system. To discover more about hypoxemia/hypoxia in COVID-19 patients, this review highlights the need for further investigation of the relationship between biochemical aberrations in erythrocytes and oxygen-transport efficiency. Furthermore, patients with severe COVID-19 experience symptoms similar to Alzheimer's, suggesting that their brains have been altered in ways that increase the likelihood of Alzheimer's. Mindful of the partly assessed role of structural, metabolic abnormalities that underlie erythrocyte dysfunction in the pathophysiology of Alzheimer's disease (AD), we further summarize the available data showing that COVID-19 neurocognitive impairments most probably share similar patterns with known mechanisms of brain dysfunctions in AD. Identification of parameters responsible for erythrocyte function that vary under SARS-CoV-2 may contribute to the search for additional components of progressive and irreversible failure in the integrated oxygen-transport system leading to tissue hypoperfusion. This is particularly relevant for the older generation who experience age-related disorders of erythrocyte metabolism and are prone to AD, and provide an opportunity for new personalized therapies to control this deadly infection.

A historical survey of the African Neo-Pentecostals’ response to digital transformation

The ongoing digital transformation (DT) in our world has not only brought change to secular systems but also to how things are done in the mission and ministry of the Christian faith. Although before the coronavirus disease 2019 (COVID-19) pandemic, some churches were interacting with DT, the post COVID-19 experience has shown that many more Christian organisations, especially, the African Neo-Pentecostal Churches (ANPC), have carved their niche in the digital space. With South Africa and Nigeria in view, this article investigated how the ANPC interacts with DT to improve missional work and the possible implications of doing so in the last 15 years. In the process, three strategies were applied. Firstly, a literature review and some online investigations were undertaken to articulate how the ANPC have engaged with DT in the past. Secondly, as a primary source, a quantitative empirical survey was conducted through data collection from 109 Neo-Pentecostal leaders to assess the current development in the use of digital technology (DTECH) by the ANPC. Thirdly, the article applied Albert Humphrey’s Strengths, Weaknesses, Opportunities and Threats (SWOT) framework to analyse the implications of the interaction. The outcome showed that the strengths and opportunities of digital interaction such as the wider and easier reach of audience, online training, online giving, improved sound and light technology and advertisements among others are helpful in missional assignments. Nevertheless, some observed Weaknesses and Threats need attention. Most importantly, the lesson from the findings is that ‘techno church’ practices come with gains; however, interaction with DT is not sufficient for missional services.Contribution: Aligning with HTS Teologiese Studies/Theological Studies’s focus and scope, this article contributed to an interdisciplinary religious aspect of research as it brought forward the interactions of African Pentecostalism, Historical Theology and Information Technology.

Explaining the role and responsibilities of the National Anti-Coronavirus Headquarters in prevention and emergency response to pandemics in the workplace: a qualitative study on COVID-19 experience in Iran

BackgroundIn recent years, the Coronavirus disease 2019 (COVID-19) have greatly affected the safety of life and the economy. Taking rapid measures to reduce these problems requires effective and efficient decisions by various departments and headquarters in a country. The purpose of this study was to investigate the role and responsibilities of the National Anti-Corona Headquarters (NACH) in the workplace during the pandemic.MethodsThis study was a qualitative study conducted using a triangulation approach. Data were obtained through semi-structured interviews with 18 participants with a purposive sampling technique as well as the review of related documents and records in response to the COVID-19 pandemic. The inductive and deductive approach was used for the content analysis of data in the Plan-Do-Check-Act (PDCA) model of the ISO45001 management system.ResultsBased on the results, four themes (plan, do, check, and act) were considered as the main domains. Subthemes include understanding the needs and expectations of interested parties; specific policy-making for organizations/workplaces; leadership and organizational commitment; addressing risks and opportunities; providing resources; competence of individuals and organizations; awareness; communication; information documentation; emergency response; monitoring, analyze, and evaluate performance; management review; non-compliance and corrective action; and improvement in pandemic control.ConclusionTo ensure the effectiveness and efficiency of organizations to deal with pandemics, the NACH must implement these responsibilities and play a pivotal role in responding to pandemics and using the participation of other government agencies and society. The findings of this study can be useful from national to local levels.

Strategic Roadmapping Framework for Disaster Response: Case of COVID-19 Pandemic Vaccine Rollout Program in the UK

Strategic planning in response to disasters is distinctly different from strategic planning in normal situations. The experience of the coronavirus disease 2019 (COVID-19) pandemic has shown that a vaccine rollout program as a disaster response requires a different approach from current routine vaccination and disaster response frameworks. A holistic conceptual framework for planning vaccine rollout disaster response programs is proposed, building on the experience of COVID-19. The customizable framework was developed to have high dynamicity, flexibility, and applicability, incorporating key decision-making factors and suitable time frames (phases and transitions), based on roadmapping principles and techniques. In this research, we focus on the COVID-19 pandemic vaccine rollout program in the United Kingdom (UK) as a representative case of disaster response planning due to the availability of public data and access to the relevant stakeholders. We applied Platts’ process approach as a methodology and used various sources of information including an extensive literature review, expert interviews, and retrospective roadmapping (mapping past experience). As a result, we propose a strategic roadmapping framework for the COVID-19 vaccine rollout program to support visual planning of time-based strategies with the integration of various resources and demand environments. Apart from this practical contribution, we demonstrate that the concept of roadmapping can be applied beyond technology and innovation management domains to a novel research domain such as disaster response.

Motivating factors of compliance to government's COVID-19 preventive guidelines: An investigation using discrete choice model

The spread of coronavirus disease 2019 (COVID-19) has resulted in a worldwide pandemic. We aimed to identify the factors that motivate public compliance with the government's COVID-19 preventive recommendations. Focus group interviews were conducted to identify influencing factors. The relative importance of each factor was investigated through a survey, based on a discrete choice model, from February to June, 2021 in South Korea. "Severity of COVID-19 symptoms" (relative importance [magnitude of attribute coefficients]: 28.40%) and "risk of infection" (27.50%) were the most influential health-related factors, followed by social consequences of infection, including "cessation of social activities due to self-quarantine" (19.77%), "risk of personal information being disclosed when infected and social criticism on the infected person" (15.78%), and "risk of spreading infection" (8.55%). Respondents behaved differently based on their socioeconomic characteristics and COVID-19 experience. The perceived severity of symptoms was a strong motivator among fragile individuals, such as women and older adults. "Cessation of social activities" was the most influential factor for those infected with COVID-19, while "risk of infection" was for those whose acquaintances were infected. The provision of information regarding COVID-19 to the public must be tailored based on an understanding of behavioral differences.

Better design leads to better results - Importance of virological outcome design in clinical trials for antiviral treatment of coronavirus disease 2019.

Better design leads to better results - Importance of virological outcome design in clinical trials for antiviral treatment of coronavirus disease 2019.

Two Years of Experience and Methodology of Korean COVID-19 Living Clinical Practice Guideline Development.

In Korea, during the early phase of the coronavirus disease 2019 (COVID-19) pandemic, we responded to the uncertainty of treatments under various conditions, consistently playing catch up with the speed of evidence updates. Therefore, there was high demand for national-level evidence-based clinical practice guidelines for clinicians in a timely manner. We developed evidence-based and updated living recommendations for clinicians through a transparent development process and multidisciplinary expert collaboration. The National Evidence-based Healthcare Collaborating Agency (NECA) and the Korean Academy of Medical Sciences (KAMS) collaborated to develop trustworthy Korean living guidelines. The NECA-supported methodological sections and 8 professional medical societies of the KAMS worked with clinical experts, and 31 clinicians were involved annually. We developed a total of 35 clinical questions, including medications, respiratory/critical care, pediatric care, emergency care, diagnostic tests, and radiological examinations. An evidence-based search for treatments began in March 2021 and monthly updates were performed. It was expanded to other areas, and the search interval was organized by a steering committee owing to priority changes. Evidence synthesis and recommendation review was performed by researchers, and living recommendations were updated within 3-4 months. We provided timely recommendations on living schemes and disseminated them to the public, policymakers and various stakeholders using webpages and social media. Although the output was successful, there were some limitations. The rigor of development issues, urgent timelines for public dissemination, education for new developers, and spread of several new COVID-19 variants have worked as barriers. Therefore, we must prepare systematic processes and funding for future pandemics.

Acute COVID-19, the Lived Experience, and Lessons to Learn for Future Pandemics.

The study aimed to increase the understanding of the lived experience of patients during the acute phase of a coronavirus disease 2019 (COVID-19) infection. A Web-based survey was distributed through established patient and public engagement and involvement groups and networks, social media, and by means of word of mouth. The survey covered questions relating to patient demographics, COVID-19 diagnosis, symptom profile, and patient experience during acute COVID-19. The findings demonstrate the varying symptom profiles experienced by people in the acute stage of COVID-19 infection, with participants sharing how they managed care at home, and/or accessed medical advice. Findings also highlight themes that people were concerned with being unable to receive care and believed they needed to rely heavily on family, with extreme thoughts of death. Although the urgent threat to public health has been negated by efficacious vaccines and enhanced treatment strategies, there are key lessons from the lived experience of COVID-19 that should be used to prepare for future pandemics and public health emergencies.

CASE REPORT: POSSIBLE COVID-19 REINFECTION IN RIYADH, SAUDI ARABIA

Coronavirus disease 2019 (COVID-19) is a clinical syndrome that results from an infection with a recently discovered strain of coronavirus. Majority of the patients suffering from COVID-19 experience clinically mild to moderate symptoms and do not require specialized clinical care. There are individuals that are asymptomatic and do not present with the clinical signs and symptoms that are characteristic of COVID-19. However, the elderly and individuals with comorbid pathological conditions such as cardiovascular diseases are at a high risk of developing a severe form of COVID-19. Currently, there is no treatment or prevention approach that has been licensed for use by the drug regulatory authorities in the care and management of persons suffering from COVID-19. Nonetheless, there are numerous ongoing clinical trials attempting to find a vaccine or cure for the disease. Since December 2019, COVID-19 has caused significant mortality and morbidity all around the world and the disease has largely disrupted the functioning of global communities. As the number of individuals who have recovered from COVID-19 continues to increase, many countries have started to re-open schools, mosques, and other public places. Medical researchers have therefore focused attention on the likelihood of re-infection with COVID-19 and the importance of acquired immunity in fighting the virus. The case report describes a 29-year-old male patient who after one month of recovery tested positive for COVID-19 infection for a second time. Extended viral shedding, dynamic polymerase chain reaction (PCR) results, and reinfection are some of the common reasons for a post-recovery positive test for COVID-19.