Management Of COVID-19 Patients Research Articles

Phytonutrient formulation using gum Arabic and Adansonia Digitata pulp: Lessons for boosting the human immune system - part 1

BackgroundThe human innate immune system (HIIs) defends the body against pathogens and relies on the energy obtained from food sources to increase its metabolic activity. AimIn this study, a new blended 3 in1 formula comprising A. senegal, A. seyal, and Adansonia digitata at a ratio of 5:3:2 was proposed as a potential aid in the management of Covid-19 patients with Metabolic Syndrome (MeT-S) disorders, with a specific focus on those presenting with impaired health. MethodsThe utilization of Inductively Coupled Plasma-Optical Emission Spectroscopy (ICP-MS) was employed to analyze 3 blended ingredient combinations, including the 3in1 formula, A. senegal, A. seyal, and A. digitata pulp, for the presence of elements by detecting the levels of moisture, ash, minerals, protein, amino acids, carbohydrates, sugars, prebiotic polysaccharides, energy, dietary fibers, and crude fibers. This advanced technique has replaced the titration method used in previous studies. ResultsThe mineral content of the blended 3in1 sample was found to be dominated by potassium (70.56±2.35), Calcium (68.54±3.12), Magnesium (16.60±4.80), Phosphorus (11.50±2.50), Sodium (31.4±4.80), Zinc (19.19±2.10), Iron (19 ± 0.14), Copper (15.12±1.81), and selenium (0.037 ± 0.005) g/100 g DW. The blended 3 in1 sample also had a higher hydroxyproline content (30.17 g/100 g and a higher total protein and carbohydrate content than the blended 2 in1 sample. Additionally, arabinose was identified as the major reducing sugar with up to 48.23 and 49.97g/100 gDW. The prebiotic polysaccharide content was 88.61±3.12g/100 gDW for the blended 3 in1 sample, which was significantly higher than that of the blended 2 in1 sample. Furthermore, the energy value of the blended 3 in1 sample was significantly higher at 350.12±5.210 kcal/100 g than the blended 2 in1 sample at 340.67±3.155 kWh. The Insoluble Dietary Fibers (IDFs) and Soluble Dietary Fibers (SDFs) of the blended 3 in1 sample were 12.6±2.10 g/100 gDW and 87±2.124 g/100 g DW, respectively, which were significantly higher than those of the blended 2 in1 sample. ConclusionThe discovery of distinct molecular compositions of A. senegal and A. seyal when combined with Adansonia Digitata Pulp (ADLP) in the 3 in1 blend demonstrated enhanced HIIs among Covid-19 patients with compromised MeT-S disorders. This may be considered a valuable natural antiviral agent for the treatment of such individuals.

A pooled analysis of the incidence and mortality risk of atrial fibrillation in patients with COVID-19.

There exist serious cardiovascular complications subsequent to SARS-Cov2 infection (COVID-19); however, the association between COVID-19 and atrial fibrillation (AF) remains to be elucidated. We aimed to assess the prevalence of AF among COVID-19 patients and its associated risk of death. The present systematic review was performed in accordance with the PRISMA guidelines. The protocol was registered with CRD42022306523. A comprehensive literature search was performed across PubMed, Embase, and Cochrane databases to identify studies reporting on the prevalence of pre-existing or new-onset fibrillation (AF), and/or the associated clinical outcomes in patients with COVID-19 from January 2020 to December 2023. The random-effect model was used to estimate the prevalence of AF and its related mortality. A total of 80 studies, including 39,062,868 COVID-19 patients, were identified in the present investigation. The prevalence rates of pre-existing AF or new-onset AF were 10.5% (95% CI [9.3-11.7%]) or 10.3% (95% CI [6.2-14.5%]), respectively. Subgroup analysis revealed a two fold higher incidence of AF in older patients (≥65 years) compared to younger patients (<65 years) (14.4% vs. 6.4%). The highest rate of AF was observed in Europeans (10.7%, 95% CI [10.2-11.2%]), followed by Northern Americans (10.0%, 95% CI [8.2-11.7%]), while Asians demonstrated a lower prevalence (2.7%, 95% CI [2.2-3.3%]). Notably, severe COVID-19 patients displayed a significantly elevated prevalence of AF at 14.l% (95% CI [13.3-14.9%]), which was approximately 2.5-fold higher than that in non-severe patients (5.2%, 95% CI [4.8-5.5%]). Both pre-existing (HR: 1.83, 95% CI [1.49-2.17]) and new-onset AF (HR: 3.47, 95% CI [2.26-5.33]) were associated with an increased mortality risk among COVID-19 patients. Furthermore, the effect on mortality risk was more significant in Asians (HR: 5.33, 95% CI [1.62-9.04]), compared to Europeans (HR: 1.68, 95% CI [1.24-2.13]) and North Americans (HR: 2.01, 95% CI [1.18-2.83]). This study comprehensively investigated the association between AF and COVID-19 in a real-world setting. Notably, a high prevalence of AF was observed among older individuals, severe COVID-19 patients, and in Europe and Northern America. Moreover, co-existing AF was found to be associated with an increased risk for mortality. Further investigations are warranted to improve the management and outcomes of COVID-19 patients with AF.

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

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

Managing COVID-19 patients with mental illness in a specialized neuropsychiatric setting: An experience from a tertiary care hospital in India.

To explore the management and outcome of COVID-19 infection in mental illness at a specialized neuropsychiatric setting. A retrospective review of the clinical profile of 100 COVID-19 patients with mental illness, admitted to the Psychiatric COVID unit (PCU) from June 2020 to June 2022, was done, with a subgroup analysis of chronic institutionalized patients (n = 36). Schizophrenia, bipolar affective disorder, and schizoaffective disorder comprised 64% of the study population. Most patients (87%) were on antipsychotics. 56% of the patients had an infection of mild severity and 38% were asymptomatic. Corticosteroids and anticoagulants were given to 33.3% and 25% of the patients, respectively. 16% of the patients encountered medical complications in the PCU, and 14% were referred to a COVID-designated hospital. Patients with diabetes mellitus and/or hypertension were more likely to be referred. The chronic institutionalized patients (n = 36) had either an asymptomatic or mild infection. Three among these patients were referred to a COVID-designated hospital. Most psychiatric patients with medical illnesses, including COVID-19, pose unique challenges including complexity of symptoms, ensuring patient safety, and the need for trained professional staff to provide specialized psychiatric interventions, which can be taken care of in psychiatric care settings.

Prone position applied to COVID-19 patients: Systematic review-meta-analysis.

Position change and interventions to increase lung capacity should be considered in mechanically ventilated patients. The most effective of these is the prone position. This systematic review and meta-analysis aimed to determine the effects of the prone position on respiratory parameters and outcomes and to guide nurses working in the intensive care unit. This systematic review-meta-analysis was conducted in accordance with the Preferred Reporting in Systematic Reviews and Meta-Analyses guideline. ScienceDirect, CINAHL, Academic Search Complete (EBSCOhost), MEDLINE, EMBASE, Web of Science, Cochrane and PubMed databases were searched between January 2022 and January 2023 to access studies related to prone position in COVID-19 patients. Twenty-three studies were included. This meta-analysis shows that a prone position is feasible and can achieve improvements in gas exchange. Prone position increases PaO2/FiO2 in the majority of patients followed with a diagnosis of COVID-19 and severe hypoxemic. The study has shown that the prone position is effective in improving patients' respiratory function and oxygenation. The results presented in this article support the notion that the prone position can be an effective strategy in the clinical management of COVID-19 patients.

Management of COVID-19 patients of CT Severity 15/25 and above with Ayurveda drugs as add-on therapy – A Case Series

Ayurveda, which is the oldest life science in the world, has yet to be fully accepted as the only or even an additional therapy for severe diseases. It is a common perception that Ayurveda has a significant role in the preventive aspect of diseases, and the drugs of Ayurveda are more effective in chronic ailments. Most publications are also limited to these areas only, as use of Ayurveda in acute or severe cases is not yet justified scientifically because of the lack of significant scientific clinical data as very few case reports are published about the use of Ayurveda in acute cases. Here we present a case series of treatment of five COVID-19 patients with CT Severity 15/25 and above with Ayurveda drugs as add-on therapy admitted to tertiary care, a Level-3 COVID-19 treatment hospital. These five patients sought Ayurveda opinion and consented to Ayurveda treatment along with the ongoing treatment regime. All the patients showed improvement with Ayurveda treatment as an add-on therapy, and none of the patients needed ICU, and all patients were discharged when they started maintaining oxygen saturation at room air. This report addresses the clinical effectiveness of Ayurveda drugs as add-on therapy in severe cases of COVID -19. It also attempts to invite the attention of researchers towards the use of Ayurveda concepts and drugs in severe or acute cases of diseases.

D-dimer as a Predictor of ICU Admission and Mortality in COVID-19 Patients: Insights From a Two-Year Retrospective Study From a Tertiary Care Center in South India.

Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced pneumonitis results in a prothrombotic and hypercoagulable state. Prognostic indicators are crucial for identifying patients at risk of complications. D-dimer, a degradation product of cross-linked fibrin, is a specific marker for thrombosis. Elevated D-dimer levels have been strongly correlated with poor prognosis and increased severity of illness in COVID-19 patients. Given D-dimer's eight-hour half-life, periodic measurement is necessary to track disease progression. This study aimed to analyze and derive threshold and peak D-dimer values to predict outcomes in COVID-19 patients, comparing those treated in isolation wards to those requiring intensive care. Methods This two-year retrospective observational study included patients above 18 years with confirmed COVID-19. Patients were categorized into those treated in isolation wards and those admitted to the intensive care unit (ICU). Based on the outcome, they were further divided into survivors and non-survivors. Demographic and outcome-related data were collected from the hospital's laboratory information system. Serial D-dimer measurements were taken at eight time points. Statistical analysis was performed using the Mann-Whitney test for laboratory values and the chi-square test for demographic data. Receiver operating characteristic (ROC) curve analysis was utilized to derive critical D-dimer values. The area under the curve (AUC) was calculated for initial and peak D-dimer values. Results Of 2.149 patients with confirmed COVID-19, 811 (38%) presented with elevated D-dimer levels. ICU admission was required for 239 patients, either due to direct admission or worsening conditions. An initial D-dimer value of ≥0.93 mg/L FEU indicated the need for ICU admission, while a peak D-dimer value of 5.65 mg/L FEU predicted mortality. The AUC for the initial D-dimer was 0.60 (95% CI: 0.55-0.64), indicating moderate discriminatory power. The AUC for the peak D-dimer was 0.58 (95% CI: 0.54-0.62), suggesting lower predictive accuracy for peak values. Sensitivity was high for both initial (0.925) and peak (0.960) D-dimer values, although specificity was lower, especially for the peak D-dimer (0.486), resulting in a higher rate of false positives. Among the ICU patients, the age range was 27-97 years, with a mean of 53.5 years. Males were more affected than females (71% vs. 29%), with a male-to-female ratio of 1.4:1. Of the ICU patients, 64.8% recovered, while 35.2% succumbed to the disease. Younger patients (mean age: 50.5 ± 12 years) recovered faster than older patients (mean age: 64 ± 16 years), with a significant difference in recovery time (p < 0.001). Gender did not significantly impact outcomes (p = 0.743). Survivors spent less time in the ICU (3-7 days) compared to non-survivors (4-14 days) (p = 0.041). Conclusion Serial D-dimer monitoring is essential for predicting outcomes and guiding treatment in COVID-19 patients. Initial and peak D-dimer values can help identify patients requiring intensive care and those at risk of mortality, allowing for timely interventions. D-dimer levels should be integrated into routine clinical assessments for managing COVID-19 patients.

A CASE-CONTROL STUDY OF HEMATOLOGICAL ANALYSIS ON DIABETES AND COVID-19 SEVERITY

This study investigates the relationship between diabetes comorbidity and COVID-19 severity in Muhammadiyah Palembang Hospital, focusing on hematological parameters as potential predictors of disease progression. Utilizing a case-control design with 61 respondents, demographic data, COVID-19 severity classifications, and hematological profiles were analyzed. Results reveal a prevalence rate of diabetes mellitus among COVID-19 patients at 32.8%, with diabetic individuals experiencing higher rates of moderate clinical complications. Hematological analysis demonstrates variations in parameters such as hemoglobin levels, platelet counts, and neutrophil-to-lymphocyte ratio between diabetic and non-diabetic COVID-19 patients. These findings underscore the importance of tailored interventions for diabetic individuals infected with COVID-19 and highlight the potential of hematological parameters in predicting disease severity. The study suggests the need for larger-scale, multicenter research to validate findings and inform evidence-based clinical practice in managing COVID-19 patients with comorbid diabetes mellitus.

Anxiety, depression, and family dysfunction among COVID-19 patients admitted to hospital and isolation facilities in the Philippines

COVID-19 patients are prone to developing psychosocial distress during and after admission to healthcare facilities. This prospective cohort study determined the prevalence of anxiety, depression, and family dysfunction among COVID-19 patients discharged from health facilities in Metro Manila, Philippines. Data was collected through phone interviews with COVID-19 patients two weeks and eight weeks after discharge. The questionnaires were based on validated tools such as HADS-P for screening anxiety and depression symptoms and Filipino Family APGAR and SCREEM Family resources survey for the perceived family function and resource, respectively. Data were analyzed using descriptive statistics to determine the prevalence of anxiety and depression symptoms. Factors associated with anxiety, depression, and family function were analyzed using logistic regression. Approximately 31.6% (23.8 – 40.2%) presented with anxiety symptoms, and 12.0% (7.3 – 18.4%) had depression symptoms two weeks after being discharged from COVID-19 infection. From two weeks after discharge, the prevalence of anxiety symptoms decreased to 19.8%, while depression increased to 13.5% eight weeks after discharge. The percentage of patients with a perceived moderate family dysfunction was 12.8% at two weeks and most inadequate resources for the patients. The patient's anxiety was associated with perceived moderate family dysfunction (p = 0.034) and moderately inadequate family resources (p = 0.034). Depression most inadequate resources for the patients. The patient's anxiety was associated with perceived moderate family dysfunction (p = 0.034) and moderately inadequate family resources (p = 0.034). Depression was associated with perceived moderate family dysfunction (p = 0.020) and low income (p = 0.036). This is one of the first studies to determine how COVID-19 infection affects the mental health status of Filipino patients. The study’s results highlight the importance of holistic care for COVID-19 patients and the need to include mental health in the management of COVID-19 patients.

COVID-19 associated pulmonary embolism: clinical, biochemical and CT imaging findings.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection represented a disruptive pathology that emerged in late 2019 with profound implications ranging from individual health to health systems and world economy. Our study aimed to evaluate clinical, biochemical and computerized tomography (CT) parameters values in determining the severity of pulmonary embolism (PE) associated with COVID-19. We performed an observational cohort study evaluating demographic, clinical, biochemical, coagulation markers, as well as CT imaging parameters. In our study on 186 patients with COVID-19, we found that 31 patients (16,66%) had pulmonary embolism. Significant correlations for the patients with PE were detected in C-reactive protein, lactate dehydrogenase, serum ferritin, IL-6, serum myoglobin, NT-proBNP, D-dimers, serum proteins, transaminases as well as white cell blood counts. Patients with pulmonary embolism had a more severe lung involvement, with thrombi distribution mainly involving the lower lobes. Early identification of PE is an important step for timely and efficient treatment in the intensive care management of COVID-19 patients. Our study showed that high plasmatic values of lactate dehydrogenase, ferritin, IL-6, white blood cells and D-dimers and low proteins serum levels are strongly linked with COVID-19-associated pulmonary embolism.

Associated factors of respiratory co-infection of COVID-19 and the impact of co-infection on SARS-CoV-2 viral load.

Emerging evidence indicates that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected individuals are at an increased risk for co-infections. This retrospective study aims to expand the knowledge of associated factors of respiratory co-infection in SARS-CoV-2 positivity. A retrospective study was conducted to recruit fifty-five patients with laboratory-confirmed SARS-CoV-2 positivity. We additionally tested 29 other respiratory pathogens using RT-PCR assay for the same specimens tested for laboratory-confirmed SARS-CoV-2. Both univariate and multivariate analysis were performed to identify independent factors for co-infection. Cox regression was conducted to detect the association between co-infection and viral load after controlling other related factors. Among all the fifty-five COVID-19 patients, the rate of co-infection with at least one other respiratory pathogen was 76.4% (42/55). The rate of bacterial co-infections was 83.3% (35/42), among which Streptococcus pneumonia was the most common co-infection. Over 70% of neutrophils proportion (OR: 4.563; 95% CI: 1.116-18.648) was an independently associated factor for bacterial co-infection, whereas fever (OR: 4.506; 95% CI: 1.044-19.441) and chest tightness (OR: 0.106; 95% CI: 0.015-0.743) for viral co-infection. The strongest promotion of SARS-CoV-2 viral decreasing load was detected from co-infection of only viruses (HR: 4.039; 95% CI: 1.238-13.177), and the weakest was found from co-infection of only bacteria (HR: 2.909; 95% CI: 1.308-6.472). Various co-infections variously promote SARS-CoV-2 viral decreasing load. Timely identification of co-infections aggressively contributes to COVID-19 patient management.

Preparedness Among Senior JKUAT Nursing Students in Managing COVID-19 Patients

The negative effects and the impact of pandemic diseases continues to grow enormously. The study aimed to find out the preparedness among senior JKUAT nursing students in managing COVID-19 patients. The purpose of the study was to determine knowledge, attitude and risk perception among senior nursing students at JKUAT in the management of COVID-19 patients. The study used a cross-sectional study design and sampling technique was used to collect data among number of students using online questionnaires. Data analysis was done using the statistical package for the social sciences version 20 and presented using frequency tables, pie charts, numerical and narratives as appropriate. Out of the total participants, 74.6% of the students were willing to volunteer in a pandemic management center and 98.6% had the knowledge on how infectious diseases are transmitted, frequent ways of transmission and prevention/minimizing the spread of infection. Nursing students are valuable resources in the health sectors and are highly willing to volunteer during the COVID-19 pandemic and are prepared to manage the affected patients. The study recommends that emergency preparedness should be integrated into the nursing curricula and other health science programs and also recommends the ministry of health to provide incentives to the volunteers as well as insurance cover in case one is infected in the line of duty.

Factors influencing healthcare workers' and health system preparedness for the COVID-19 pandemic: A qualitative study in Ghana.

Adequate preparedness of health systems, particularly healthcare workers (HCWs), to respond to COVID-19 is critical for the effective control of the virus, especially in low- and middle-income countries where health systems are overburdened. We examined Ghanaian HCWs' perceived preparedness to respond to the pandemic and the factors that shaped their preparedness and that of the health system. Semi-structured in-depth interviews were conducted with n = 26 HCWs responsible for the clinical management of COVID-19 patients and three administrators responsible for developing and implementing COVID-19 policies at the facility level. Interviews were conducted over the phone in English, transcribed, and analyzed using a thematic analysis approach. Generally, HCWs felt inadequately prepared to contain the spread of COVID-19 due to resource shortages and inadequate training. HCWs, similarly, perceived the health system to be unprepared due to insufficient clinical infrastructure and logistical challenges. The few who felt prepared identified readiness in managing high consequence infectious disease cases and pre-existing protocols as enablers of HCW preparedness. The health system and HCWs were unprepared to manage the COVID-19 pandemic due to inadequate training, logistical challenges, and weak clinical infrastructure. Interventions are urgently needed to improve the health system's preparedness for future pandemics.

Cerebral microbleeds in patients with COVID-19: is there an inevitable connection?

The COVID-19 pandemic has underscored the critical interplay between systemic infections and neurological complications, notably cerebral microbleeds. This comprehensive review meticulously aggregates and analyses current evidence on cerebral microbleeds' prevalence, pathophysiological underpinnings and clinical implications within COVID-19 cohorts. Our findings reveal a pronounced correlation between cerebral microbleeds and increased severity of COVID-19, emphasizing the role of direct viral effects, inflammatory responses and coagulation disturbances. The documented association between cerebral microbleeds and elevated risks of morbidity and mortality necessitates enhanced neurological surveillance in managing COVID-19 patients. Although variability in study methodologies presents challenges, the cumulative evidence substantiates cerebral microbleeds as a critical illness manifestation rather than mere coincidence. This review calls for harmonization in research methodologies to refine our understanding and guide targeted interventions. Prioritizing the detection and study of neurological outcomes, such as cerebral microbleeds, is imperative for bolstering pandemic response strategies and mitigating the long-term neurological impact on survivors.

Enhancing the capacity of community health workers in prevention and control of epidemics and pandemics in Wakiso district, Uganda: evaluation of a pilot project

BackgroundCommunity Health Workers (CHWs) play a crucial role in outbreak response, including health education, contact tracing, and referral of cases if adequately trained. A pilot project recently trained 766 CHWs in Wakiso district Uganda on epidemic and pandemic preparedness and response including COVID-19. This evaluation was carried out to generate evidence on the outcomes of the project that can inform preparations for future outbreaks in the country.MethodsThis was a qualitative evaluation carried out one year after the project. It used three data collection methods: 30 in-depth interviews among trained CHWs; 15 focus group discussions among community members served by CHWs; and 11 key informant interviews among community health stakeholders. The data was analysed using a thematic approach in NVivo (version 12).ResultsFindings from the study are presented under four themes. (1) Improved knowledge and skills on managing epidemics and pandemics. CHWs distinguished between the two terminologies and correctly identified the signs and symptoms of associated diseases. CHWs reported improved communication, treatment of illnesses, and report writing skills which were of great importance including for managing COVID-19 patients. (2) Enhanced attitudes towards managing epidemics and pandemics as CHWs showed dedication to their work and more confidence when performing tasks specifically health education on prevention measures for COVID-19. (3) Improved health practices such as hand washing, vaccination uptake, and wearing of masks in the community and amongst CHWs. (4) Enhanced performance in managing epidemics and pandemics which resulted in increased work efficiency of CHWs. CHWs were able to carry out community mobilization through door-to-door household visits and talks on community radios as part of the COVID-19 response. CHWs were also able to prioritize health services for the elderly, and support the management of patients with chronic diseases such as HIV, TB and diabetes by delivering their drugs.ConclusionsThese findings demonstrate that CHWs can support epidemic and pandemic response when their capacity is enhanced. There is need to invest in routine training of CHWs to contribute to outbreak preparedness and response.

Determining the frequency of thyroid involvement in chest CT scans of COVID-19 patients and its correlation with the severity of lung involvement and survival of patients in 2020.

This study aimed to determine the frequency of thyroid gland involvement in chest CT scans of patients with COVID-19 admitted to university-affiliated hospitals and assess its relationship with the severity of lung involvement and patient survival in 2020. In this retrospective cross-sectional study, 1000 PCR-positive patients with COVID-19 who were referred to University-affiliated Hospital in 2020 and had chest CT performed within 72 hours of admission to the hospital were examined. The data was collected by patient file information and CT findings recorded in the PACS system, including thyroid involvement, the severity of lung involvement, and findings related to the death and recovery of patients. The mean age of the examined patients was 56 years. 525 people (52.5%) were men, and 475 (47.5%) were women. 14% had severe pulmonary involvement, and 9.3% had very severe involvement. Moreover, 15.9 percent of them had deceased. 19.7% had focal thyroid involvement, 14% had diffuse involvement, and 66.3% were healthy subjects. Male gender and older age showed a significant relationship with thyroid gland involvement. The severity of lung involvement, the death rate in patients, and hospitalization in ICU were also significantly related to thyroid gland involvement in patients with COVID. This study highlights the importance of considering thyroid-gland involvement in the comprehensive management of COVID-19 patients. Routine screening and monitoring of thyroid-function may facilitate earlier detection and appropriate management of thyroid-related complications, potentially improving clinical outcomes. This study suggests that in COVID-19 infection the monitoring of thyroid function is prudent, particularly in cases of more serious disease.

COVID-19 and Pneumonia detection and web deployment from CT scan and X-ray images using deep learning.

During the COVID-19 pandemic, pneumonia was the leading cause of respiratory failure and death. In addition to SARS-COV-2, it can be caused by several other bacterial and viral agents. Even today, variants of SARS-COV-2 are endemic and COVID-19 cases are common in many places. The symptoms of COVID-19 are highly diverse and robust, ranging from invisible to severe respiratory failure. Current detection methods for the disease are time-consuming and expensive with low accuracy and precision. To address such situations, we have designed a framework for COVID-19 and Pneumonia detection using multiple deep learning algorithms further accompanied by a deployment scheme. In this study, we have utilized four prominent deep learning models, which are VGG-19, ResNet-50, Inception V3 and Xception, on two separate datasets of CT scan and X-ray images (COVID/Non-COVID) to identify the best models for the detection of COVID-19. We achieved accuracies ranging from 86% to 99% depending on the model and dataset. To further validate our findings, we have applied the four distinct models on two more supplementary datasets of X-ray images of bacterial pneumonia and viral pneumonia. Additionally, we have implemented a flask app to visualize the outcome of our framework to show the identified COVID and Non-COVID images. The findings of this study will be helpful to develop an AI-driven automated tool for the cost effective and faster detection and better management of COVID-19 patients.

Genomic epidemiology of SARS-CoV-2 in Senegal in 2020-2021.

In Senegal, molecular diagnosis was widely used for the detection and management of COVID-19 patients. However, genomic surveillance was very limited in the public sector. This study aimed to share the experience of a Senegalese public sector laboratory in response to the COVID-19 pandemic, and to describe the distribution of variants circulating in 2020 and 2021. From July 2020 to December 2021, SARS-CoV-2 qRT-PCR was performed on nasopharyngeal samples from travelers and symptomatic patients at the Bacteriology and Virology Laboratory (LBV) of the Aristide le Dantec University Teaching Hospital. Samples with a cycle threshold (Ct) ≤ 30 were selected for whole-genome sequencing (WGS) using the Nanopore technology. In-house scripts were developed to study the spatial and temporal distribution of SARS-CoV-2 variants in Senegal, using our sequences and those retrieved from the GISAID database. Of 8,207 patients or travelers screened for SARS-CoV-2, 970 (11.8%) were positive and 386 had a Ct ≤ 30. WGS was performed on 133 samples. Concomitantly with high-quality sequences deposited in the GISAID database covering nine cities in Senegal in 2020 and 2021 (n = 1,539), we observed a high circulation of the 20A (B.1, B.1.416 and B.1.620) and 20B (B.1.1.420) lineages in 2020, while most of the samples belonged to Delta variants (AY34 and AY.34.1, 22%) in 2021. Despite its late involvement, COVID-19 diagnosis was routinely performed in LBV, but genomic characterization remained challenging. The genomic diversity of SARS-CoV-2 strains in Senegal reflected that observed worldwide during the first waves of the pandemic.

A Perspective on Gastrointestinal Complications in COVID-19: Clinical Features, Diagnosis, Research, Mechanisms, and Multidisciplinary Management

Abstract: The emergence of COVID-19 caused by SARS-CoV-2 has transformed our understanding of the disease, transcending its initial characterization as a respiratory ailment. Acknowledged now as a multisystem dysfunctional disorder, COVID-19 exhibits a diverse range of symptoms, notably affecting the Gastrointestinal (GI) system. This article delves into the evolving comprehension of COVID-19 as a multisystem disease, emphasizing its GI complications, including diarrhea, anorexia, nausea, vomiting, and stomach discomfort. The exploration encompasses clinical features, diagnostic methods, and research advancements related to COVID-19's impact on the GI system. It accentuates the intricate link between gut and lung health, advocating a multidisciplinary approach for patients with GI involvement. The review addresses innovative diagnostic techniques tailored for GI symptoms and discusses emerging trends and breakthroughs in clinical research. Moreover, it analyzes the mechanisms underpinning COVID-associated GI damage, emphasizing the interplay between gut and lung pathophysiology, thereby deepening our understanding of the disease process. The article proposes a comprehensive approach to managing COVID-19 patients with GI complications, advocating stringent hygiene, detailed patient history analysis, consideration of preexisting conditions, and exploration of various treatments, such as microbiome-targeted therapeutics, ACE2 inhibitors, antibiotics, plasma therapy, and vaccines. Additionally, it highlights the role of nutritional supplements and vitamins in supporting GI health during COVID-19. This content offers valuable insights for clinicians, researchers, and policymakers, providing a roadmap for effective multidisciplinary management tailored to GI manifestations in the COVID-19 pandemic. Through a thorough examination of clinical aspects, diagnostics, mechanisms, and management strategies, this review contributes significantly to the collective knowledge, enhancing our ability to combat COVID-19 comprehensively.

Role of Melatonin in Management of COVID-19: A Systematic Review

Background: the COVID-19 pandemic has significantly impacted global healthcare and economic systems. The clinical manifestation of the disease varies from flu-like symptoms to severe pneumonia and, in some cases, death. Melatonin and its metabolites play a crucial role in immunomodulation and possess anti-oxidative properties, capable of directly and indirectly scavenging reactive oxygen species. Objective: the aim of the present systematic review was to assess the effectiveness of melatonin in the management of COVID-19 patients and its role in expediting the return of patients to their baseline health. Methodology: the literature review was conducted up to August 2022, resulting in the identification of 533 articles after sorting them by authors and year of publication. Following the removal of 223 duplicate articles, 310 abstracts were screened, leading to the exclusion of 281. Subsequently, 29 full-text studies were evaluated for eligibility, with 22 being excluded. Finally, seven studies met the inclusion criteria and were included for further qualitative and quantitative analyses. Results: the findings revealed a noteworthy reduction in hospital stay among patients who received melatonin compared to those who received a placebo (standardized mean difference: -0.50, Standard error: 0.15, 95% CI: -0.80, -0.20, P value: 0.001). Melatonin was associated with a significant decrease in mortality in COVID-19 patients when compared to the placebo (Pooled RR: 0.21, 95% CI: 0.08, 0.56, P value: 0.002). However, there were no significant differences between melatonin and placebo regarding the need for hospitalization, ICU admission, artificial ventilation, and the requirement for oxygen therapy. Conclusion: melatonin may decrease the mortality rate among patients with COVID-19. Melatonin may reduce the duration of hospital stay in patients with COVID-19. Melatonin had no effect on the following outcomes in COVID-19 patients: the need for hospitalization, ICU admission, artificial ventilation and the need for oxygen therapy.