Number Of Severe Cases Research Articles

Dengue outbreaks in Brazil and Latin America: the new and continuing challenges

ObjectivesTo compare the number of suspected cases, severe cases, and deaths of dengue in 2023 and 2024 in Brazil and Latin America; and to describe its epidemiological profile. DesignObservational study. MethodsThe data regarding dengue was retrieved from the Brazilian Ministry of Health website. The Chi-square test was used to compare the proportion of dengue cases in 2023 and 2024 according to gender, race, and age range. The odds ratio and the 95% confidence intervals were used to describe the data. The Spearman correlation test was used to compare the number of suspected cases, severe cases, and deaths of dengue with the number of distributed vaccines against dengue. ResultsDengue is one of the most common zoonoses in Latin America. In 2023, Brazil registered a total of 1,658,814 suspected cases of dengue with 1094 deaths. For 2024, a total of 1,978,372 suspected cases of dengue were reported only until the 11th epidemiological week, with 656 deaths. When comparing dengue cases reported in 2024 and 2023, there is an increase in suspected cases, with 20% more cases reported during the first 11 epidemiological weeks of 2024 than in the entire 52 epidemiological weeks of 2023. At the same time, in 2024, the Pan American Health Organization reported suspected cases in 20 Latin American countries, with 3073 cases of severe dengue and 1187 deaths. In Brazil, a different racial profile for dengue was described since Black people [OR = 1.56 (95% CI = 1.54-1.57)], Mixed individuals [OR = 1.36 (95% CI = 1.35-1.37), and Indigenous peoples [OR = 1.77 (95% CI = 1.70-1.85)] were more likely to be suspected cases of dengue in 2024 compared to 2023. Also, a positive correlation between the distributed vaccines with deaths due to dengue and the number of severe cases was described. ConclusionBrazil was responsible for more than 50% of suspected cases and deaths from dengue compared to the other Latin American countries in 2024. Furthermore, there is a different racial profile for dengue in Brazil, as Black people, Mixed individuals, and Indigenous peoples were more likely to be suspected cases of dengue in 2024 compared to 2023.

Development and validation of a scoring system to predict the mortality of hospitalized patients with SARS-CoV-2 Omicron: a nationwide, multicentre study

BackgroundThe Omicron variant broke out in China at the end of 2022, causing a considerable number of severe cases and even deaths. The study aimed to identify risk factors for death in patients hospitalized with SARS-CoV-2 Omicron infection and to establish a scoring system for predicting mortality.Methods1817 patients were enrolled at eight hospitals in China from December 2022 to May 2023, including 815 patients in the training group and 1002 patients in the validation group. Forty-six clinical and laboratory features were screened using LASSO regression and multivariable logistic regression.ResultsIn the training set, 730 patients were discharged and 85 patients died. In the validation set, 918 patients were discharged and 84 patients died. LASSO regression identified age, levels of interleukin (IL) -6, blood urea nitrogen (BUN), lactate dehydrogenase (LDH), and D-dimer; neutrophil count, neutrophil-to-lymphocyte ratio (NLR) as associated with mortality. Multivariable logistic regression analysis showed that older age, IL-6, BUN, LDH and D-dimer were significant independent risk factors. Based on these variables, a scoring system was developed with a sensitivity of 83.6% and a specificity of 83.5% in the training group, and a sensitivity of 79.8% and a sensitivity of 83.0% in the validation group.ConclusionsA scoring system based on age, IL-6, BUN, LDH and D-dime can help clinicians identify patients with poor prognosis early.

Trend differences in cervical spinal cord injuries before and after the coronavirus disease 2019 pandemic.

Cross-Sectional Study. To investigate the changes in the characteristics of cervical spinal cord injuries (CSCI) before and after the coronavirus disease 2019 (COVID-19) pandemic among patients transported to our hospital in Japan. Hospital with an emergency center in Chiba, Japan. Patients eligible for the study were those transported within 24 h of injury and diagnosed with cervical spinal cord injury between January 2018 and December 2021 at our hospital. Medical records were retrospectively examined to investigate the number and characteristics of patients with CSCI. The clinical variables of patients with CSCI were compared according to the time of admission as related to the COVID-19 pandemic: 2018-19 (before) or 2020-21 (after). The total number of patients with CSCI from 2018 to 2021 was 108, with 57 before the COVID-19 pandemic and 51 after the COVID-19 pandemic. The number of severe cases with an injury severity score (ISS) of >16 decreased after COVID-19 (p < 0.05). Falls on level surfaces were the most common cause of injury both before and after COVID-19. Although the ranking of traffic accidents decreased after COVID-19, among those, the number of bicycle injuries tended to increase. The number of serious cases with an ISS > 16 decreased, presumably because of the decline in high-energy trauma due to the background decrease in the number of traffic accidents.

Health economic analysis and medical cost analysis of children with severe hepatitis B in China: A retrospective study from 2016 to 2022.

Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China. Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran's Ianalysis. The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603,) of total cases and cirrhosis cases accounted for 11.23% (180/1603,). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (GDP, Moran's I <0) and percentage of urban population (Moran's I <0), and positively correlated with the number of pediatric beds per million population (Moran's I >0). The number of severe hepatitis B cases is low in areas with high GDP levels and high urban population ratios, and health care costs have been declining over the years.

Optimal non-pharmaceutical interventions considering limited healthcare system capacity and economic costs in the Republic of Korea

Due to the relatively low severity and fatality rates of the omicron variant of COVID-19, strict non-pharmaceutical interventions (NPIs) with high economic costs may not be necessary. We develop a mathematical model of the COVID-19 outbreak in Korea that considers NPIs, variants, medical capacity, and economic costs. Using optimal control theory, we propose an optimal strategy for the omicron period. To suggest a realistic strategy, we consider limited hospital beds for severe cases and incorporate it as a penalty term in the objective functional using a logistic function. This transforms the constrained problem into an unconstrained one. Given that the solution to the optimal control problem is continuous, we propose the adoption of a sub-optimal control as a more practically implementable alternative. Our study demonstrates how to strategically balance the trade-off between minimizing the economic cost for NPIs and ensuring that the number of severe cases in hospitals is manageable.

International scientific communication on COVID-19 data: management pitfalls understanding.

During the pandemic, countries utilized various forms of statistical estimations of coronavirus disease-2019 (COVID-19) impact. Differences between databases make direct comparisons and interpretations of data in different countries a challenge. We evaluated country-specific approaches to COVID-19 data and recommended changes that would improve future international collaborations. We compared the COVID-19 reports presented on official UK (National Health System), Israeli (Department of Health), Latvian (Center for Disease Prevention and Control) and USA (Centers for Disease Control and Prevention) health authorities' websites. Our analysis demonstrated critical differences in the ways COVID-19 statistics were made available to the general and scientific communities. Specifically, the differences in approaches were found in the presentation of the number of infected cases and tests, and percentage of positive cases, the number of severe cases, the number of vaccinated, and the number and percent of deaths. Findability, Accessibility, Interoperability and Reusability principles could guide the development of essential global standards that provide a basis for communication within and outside of the scientific community.

First Report of Globisporangium spinosum Causing Root Rot of Panax notoginseng in China.

Panax notoginseng (Burkill) F.H. Chen, known as ''sanqi'', is widely used for its medicinal and tonic effects in China, such as treatment of cardiovascular diseases and antioxidant effects. However, root rot disease is the most destructive disease that hampers industrial development (Mi et al. 2017). In August 2018 and 2019, samples displaying symptoms of root rot, such as unnormal, stunted growth and chlorotic leaves, were dug out with a shovel and put in clean sample-bags from four production bases in Wenshan (around 23.5° N; 104° E), Yunnan province, the biggest "sanqi" production area in China, with over 20 thousand ha. Among production bases, root rot incidence typically ranged from 10% to 20%, but in a few number of severe cases, exceeded 70%. Typical symptomatic root tubers were washed with tap water, surface-sterilized in 5% NaClO for 1 min followed by 70% alcohol for 30 s, and rinsed three times with sterile water. The diseased tissues were excised and placed on rye sucrose agar medium (RSA) supplemented with 25 mg/L rifampin and 50 mg/L kanamycin, then incubated at 25°C in the dark for five days. Colonies with different features grew from the diseased pieces and twenty oomycete-like colonies, (white, dense, aerial mycelia with rapid radiate growth) were chosen for further investigation. Microscopic observations showed terminal and intercalary hyphal swellings, which were either globose or limoniform, thin-walled, mostly smooth, and 13-28 µm wide (average 20.3 µm). Oogonia were globose or rarely fusiform, mostly intercalary, 11-19 µm wide (average 13 µm), provided with a varying number of blunt, digitate projections. Oospores were plerotic, rarely aplerotic, thin-walled, and 16-19 μm wide (average 18.6 μm). Antheridia usually originated at various distances from the oogonium and appeared- clavate and crook-necked, making apical contact with the oogonium. Based on typical morphological features described, the isolates were putatively identified as Pythium spinosum (van der Plaats-Niterink 1981). The internal transcribed spacer region (ITS) and cytochrome c oxidase subunit II (CoxII) of isolates SQ00803 and SQ00903-1 were sequenced using universal primers ITS1/ITS4 and FM58/FM66 (Villa et al. 2006). The nucleotide sequences were deposited to GenBank with the accession numbers MN369530, MN370548, MN561687 and MN561688, respectively. Blastn analysis of ITS sequences showed 99.58% similarity to those of Globisporangium spinosum isolates CBS275.67 and CBS276.67 (accession number AY598701 and HQ643792). CoxII sequences showed 99.82% to 100% similarity to G. spinosum isolates (accession number GU071755 and AF196616). For pathogenicity tests, nine two-year-old healthy sanqi plants grown in sterilized substrate in plastic pots under greenhouse conditions were inoculated with 5×104 CFU/ml zoospore suspension of G. spinosum by root-drenching method (Dixon et al. 1984). Three non-inoculated plants drenched with sterile water were used as controls. All plants were incubated in a growth chamber at 25°C with a 16/8-h photoperiod. After two weeks, inoculated sanqi plants showed discoloration and chlorosis of leaves with water-soaked root rot. Control plants were symptomless and healthy. Colonies resembling G. spinosum were re-isolated from infected root tissues and showed the same morphological features as G. spinosum, thus fulfilling Koch's postulates. G. spinosum originally isolated from seedlings of Anthirrhinum majus has been reported to cause root rot disease on many plant species worldwide (Lévesque and De Cock 2004). Recently, based on whole genome sequencing and phylogenomic analysis, P. spinosum was transferred to Globisporangium genus. Therefore, P. spinosum is now classified as G. spinosum (Hai et al. 2022). To our knowledge, this is the first report of G. spinosum causing root rot of P. notoginseng in China. This research will contribute to the development of integrated management strategies for P. notoginseng root rot.

ThTP8.9 The SARS-CoV-2 first wave impact in the acute inflammatory surgical pathologies

Abstract Anecdotal evidence suggests that community infection control measures during the COVID-19 outbreak have modified the number and natural history of acute surgical inflammatory processes (ASIP-appendicitis, cholecystitis, diverticulitis and perianal abscesses) admissions. This study aims to evaluate the impact of the COVID-19 pandemic on the presentation and treatment ASIP and quantify the effect of COVID-19 infection on the outcomes of ASIP patients. This was a multicentre, comparative study, whereby ASIP cases from 2019, 2020 and 2021 (March 14th to May 2nd) were analyzed. Data regarding patient and disease characteristics as well as outcomes, were collected from sixteen centres in Madrid, and one in Seville (Spain). The number of patients treated for ASIP in 2019 was 822 compared to 521 in 2020 and 835 in 2021. This 1/3rd reduction occurs mainly in patients with mild cases, while the number of severe cases was similar. Surgical standards suffered a step back during the first wave: Lower laparoscopic approach and longer length of stay. We also found a more conservative approach to the patients this year, non-justified by clinical circumstances. Luckily these standards improved again in 2021. The positive COVID-19 status itself did not have a direct impact on mortality. Strikingly, none of the 33 surgically treated COVID positive patients during both years died postoperatively. This is an interesting finding which, if confirmed through future research with a larger sample size of COVID-19 positive patients, can expedite the recovery phase of acute surgical services.

The methodology of the development of original medicines based on the medicinal plant raw material for the treatment of inflammatory bowel diseases

According to the Ministry of Health of Ukraine, the number of patients with IBD in Ukraine is approximately 30,000 people per 100,000 population, half of which have a medium or severe degree of damage.&#x0D; Over the past 5 years, there has been a trend towards an increase in the number of severe cases and treatment-resistant forms of chronic intestinal diseases of an inflammatory nature, which often requires surgical intervention or causes the development of complications, which, in turn, can lead to invalidation of patients and, as a result, causes significant economic costs, related to their care, treatment and rehabilitation. The most common are Crohn’s disease and ulcerative colitis.&#x0D; The prevalence of ulcerative colitis (UC) in the population ranges from 21 to 268 cases per 100,000 people. The social significance of UC lies in the fact that the incidence is predominant among young people. Thus, statistical data show that the peak incidence of UC occurs at the age of 20–30 years. In the absence of appropriate therapy, the course of UC is recurrent and remitting.&#x0D; In the process of work, the methods of analysis of electronic and paper sources of information were used, on providing the domestic pharmaceutical market with drugs for the treatment of IBD, their directions and mechanism of action, the possibility of using in the therapy of diseases with herbal medicines containing BAS, that affect various links of the pathogenetic process, the possibility of combining it with synthetic API in order to increase the effectiveness of treatment.&#x0D; The algorithm of the methodology consists of three blocks: information and search, research and biological. Each block, which ends with obtaining an intermediate result, ensures the setting of the task for the next stage of the research.

Upcoming epidemic storm: Empirical formulas, biosynthesis reactions, thermodynamic properties and driving forces of multiplication of the omicron XBB.1.9.1, XBF and XBB.1.16 (Arcturus) variants of SARS-CoV-2

COVID-19 and SARS-CoV-2 from the perspectives of medicine, biology, molecular biology, chemistry and biothermodynamics represent probably the best studied virus-host interaction until now. Empirical formula of SARS-CoV-2 is the second reported in history, immediately after the poliovirus. Empirical formulas of all SARS-CoV-2 variants have been reported in the literature. This paper reports empirical formulas, biosynthesis reactions and thermodynamic properties (enthalpy, entropy and Gibbs energy) for the XBB.1.9.1, XBF and XBB.1.16 variants of SARS-CoV-2. Since Gibbs energy of biosynthesis represents the driving force for virus multiplication, a conclusion was made that multiplication rate of the new SARS-CoV-2 variants is not significantly different than that of the other Omicron variants. Since multiplication rate determines the damage level to host cells, a conclusion was drawn that there is no increase in the degree of damage to host tissues. Thus, pathogenicity of the new variants did not significantly change. In that case, it can be expected that the number of severe cases should not increase. Therefore, it seems that the health risk for the society should not change.

Forecast for peak infections in the second wave of the Omicron after the adjustment of zero-COVID policy in the mainland of China.

On December 7, 2022, the Chinese government optimized the current epidemic prevention and control policy, and no longer adopted the zero-COVID policy and mandatory quarantine measures. Based on the above policy changes, this paper establishes a compartment dynamics model considering age distribution, home isolation and vaccinations. Parameter estimation was performed using improved least squares and Nelder-Mead simplex algorithms combined with modified case data. Then, using the estimated parameter values to predict a second wave of the outbreak, the peak of severe cases will reach on 8 May 2023, the number of severe cases will reach 206,000. Next, it is proposed that with the extension of the effective time of antibodies obtained after infection, the peak of severe cases in the second wave of the epidemic will be delayed, and the final scale of the disease will be reduced. When the effectiveness of antibodies is 6 months, the severe cases of the second wave will peak on July 5, 2023, the number of severe cases is 194,000. Finally, the importance of vaccination rates is demonstrated, when the vaccination rate of susceptible people under 60 years old reaches 98%, and the vaccination rate of susceptible people over 60 years old reaches 96%, the peak of severe cases in the second wave of the epidemic will be reached on 13 July 2023, when the number of severe cases is 166,000.

Correlation of Mucormycosis with Various Clinical Parameters Among COVID-19 Patients: A Cross-Sectional Study.

Coronavirus disease 2019 (COVID-19), during the second wave in early 2021, caused devastating chaos in India. As daily infection rates continue to rise alarmingly, the number of severe cases also increased dramatically. Mucormycosis is an infection caused by filamentous molds, and there was a rise in mucormycosis cases after COVID-19 infection. The aim of the study is to assess various parameters associated with mucormycosis patients who suffered from COVID-19. This study was a cross-sectional questionnaire study. The target population for the study were 70 mucormycosis-infected patients (51 = males, 19 = females). The questionnaire mainly focused on association of various parameters of COVID-19 with mucormycosis. Result showed that out of 70 cases of mucormycosis the association was found between history of diabetes mellitus 45 (64.2%), type of hospitalization, number of days of hospitalization, oxygen administered, type and maintenance of face mask, i.e., patient who had reused mask by washing 59 (84.3%), and method of oral hygiene practices. Mucormycosis is extremely rare in population. The study findings emphasize the need to be aware of invasive mucormycosis developing in COVID-19 patients, especially including patients with diabetes mellitus and outside the ICU, patient who had poor oral hygiene during COVID-19, patients receiving oxygen therapy should ensure that the water in the humidifier is clean and is refilled regularly, knowledge and education about the use of the facemask.

The Effects of CoronaVac and ChAdOx1 nCoV-19 in Reducing Severe Illness in Thailand: A Retrospective Cohort Study.

Two primary vaccines for coronavirus disease 2019 (COVID-19) have been rolled out in the mass vaccination campaign that started simultaneously with the spread of the delta variant. To explore the vaccines' effect on reducing viral load and disease severity, we conducted a retrospective cohort study in Thai patients aged ≥18 years who were confirmed COVID-19 positive by RT-PCR. Compared to unvaccinated patients, Ct values and the number of severe cases among vaccine regimens were analyzed. Ct values of vaccinated patients were not significantly different from unvaccinated patients, despite an increase of Ct values in a booster dose. The adjusted odd ratio for prevention of delta-related severe diseases was 0.47, 95% CI: 0.30-0.76 and 0.06, 95% CI: 0.01-0.45 after receiving one dose and two doses, respectively. No severe illness was found in booster-vaccinated individuals. Focusing on the vaccine types, one dose of ChAdOx1 nCoV-19 gave significant protection, whereas one dose of CoronaVac did not (0.49, 95% CI: 0.30-0.79, p = 0.003 vs. 0.28, 95% CI: 0.04-2.16, p = 0.223). Two-dose vaccination showed robust protective effects in all subpopulations regardless of vaccine type. Vaccinations with two primary vaccines could not reduce viral load in patients with COVID-19, but could prevent severe illness.

Estimated public health impact of human rotavirus vaccine (HRV) and pneumococcal polysaccharide protein D-conjugate vaccine (PHiD-CV) on child morbidity and mortality in Gavi-supported countries

ABSTRACT Vaccine impact models against rotavirus disease (RD) and pneumococcal disease (PD) in low- and middle-income countries assume vaccine coverage based on other vaccines. We propose to assess the impact on severe disease cases and deaths avoided based on vaccine doses delivered by one manufacturer to Gavi-supported countries. From the number of human rotavirus vaccine (HRV) and pneumococcal polysaccharide protein D-conjugate vaccine (PHiD-CV) doses delivered, we estimated the averted burden of disease 1) in a specific year and 2) for all children vaccinated during the study period followed-up until 5 years (y) of age. Uncertainty of the estimated impact was assessed in a probabilistic sensitivity analysis using Monte-Carlo simulations to provide 95% confidence intervals. From 2009 to 2019, approximately 143 million children received HRV in 57 Gavi-supported countries, avoiding an estimated 18.7 million severe RD cases and 153,000, deaths. From 2011 to 2019, approximately 146 million children received PHiD-CV in 36 countries, avoiding an estimated 5.0 million severe PD cases and 587,000 deaths. The number of severe cases and deaths averted for all children vaccinated during the study period until 5 years of age were about 23.2 million and 190,000, respectively, for HRV, and 6.6 million and 749,000, respectively, for PHiD-CV. Models based on doses delivered help to assess the impact of vaccination, plan vaccination programs and understand public health benefits. In 2019, HRV and PHiD-CV doses delivered over a 5-y period may have, on average, averted nine severe disease cases every minute and one child death every 4 min.

COVID-19 public health and social measures: a comprehensive picture of six Asian countries

The COVID-19 pandemic will not be the last of its kind. As the world charts a way towards an equitable and resilient recovery, Public Health and Social Measures (PHSMs) that...

An average of nearly 200,000 new infections per day over a six-week period: What is the impact of such a severe COVID-19 pandemic on the healthcare system in Japan?

During a six-week period from July 20 to August 31, 2022, Japan experienced its highest level of COVID-19 infection ever, with an average of nearly 200,000 new infections per day nationwide. Cases requiring inpatient care peaked at 1,993,062. Twenty-seven prefectures (out of 47 prefectures) had an average hospital bed occupancy of 50% or higher, and bed occupancy in Kanagawa in particular reached 98% in mid-August. In Tokyo, bed occupancy by patients with severe COVID-19 reached 57% and peaked at 64% in mid-August. Although the number of new infections per day has decreased since September, hospital bed occupancy, the number of severe cases, and deaths remain high nationwide. Efforts including vaccination campaigns, domestic surveillance, and routine infection control measures based on the varied knowledge that the Japanese public already has should be thoroughly implemented to reduce the number of the infected in order to avoid an increase the number of serious cases and deaths.

Predicting SARS-CoV-2 Variant Spread in a Completely Seropositive Population Using Semi-Quantitative Antibody Measurements in Blood Donors.

SARS-CoV-2 serologic surveys estimate the proportion of the population with antibodies against historical variants, which nears 100% in many settings. New approaches are required to fully exploit serosurvey data. Using a SARS-CoV-2 anti-Spike (S) protein chemiluminescent microparticle assay, we attained a semi-quantitative measurement of population IgG titers in serial cross-sectional monthly samples of blood donations across seven Brazilian state capitals (March 2021–November 2021). Using an ecological analysis, we assessed the contributions of prior attack rate and vaccination to antibody titer. We compared anti-S titer across the seven cities during the growth phase of the Delta variant and used this to predict the resulting age-standardized incidence of severe COVID-19 cases. We tested ~780 samples per month, per location. Seroprevalence rose to >95% across all seven capitals by November 2021. Driven by vaccination, mean antibody titer increased 16-fold over the study, with the greatest increases occurring in cities with the highest prior attack rates. Mean anti-S IgG was strongly correlated (adjusted R2 = 0.89) with the number of severe cases caused by Delta. Semi-quantitative anti-S antibody titers are informative about prior exposure and vaccination coverage and may also indicate the potential impact of future SARS-CoV-2 variants.

Efficacy of intravenous vitamin C in management of moderate and severe COVID-19: A double blind randomized placebo controlled trial.

To study the efficacy of intravenous vitamin C in management of moderate and severe COVID-19. To determine the efficacy of intravenous vitamin C in reducing in-hospital mortality in moderate and severe cases of COVID-19. Parallel, double-blinded randomized controlled trial with placebo. Ethical clearance was obtained from the institutional ethics committee, AIIMS Patna. The trial was registered with the Clinical Trials Registry - India (registration number- CTRI/2020/11/029230.). A tertiary care centre in Bihar, India. All patients above the age of 18 years both males and females, admitted in ICU with a diagnosis of moderate and severe COVID-19 (on the basis of a positive reverse transcriptase polymerase chain reaction (RT-PCR) report) at our facility during the study period (01/10/2020-31/12/2020) not having any of the exclusion criteria. The patients in the intervention arm were given 1 gram (2 ampoules of 2 ml each containing 500 mg of vitamin C mixed in 100 ml normal saline) intravenous vitamin C 8 hourly for four days. The patients in the placebo arm received similar looking ampoules (2 ampoules of 2 ml sterile water for injection mixed in 100 ml normal saline) intravenously 8 hourly for four days. The rest of the treatment was given as per the standard operating procedure (SOP) of the institute with adjustments as per treating team's judgement. Primary outcome was reduction in in-hospital mortality. Secondary outcomes were improvement in qSOFA score, pO2/fiO2 ratio, fall in inflammatory markers, need for mechanical ventilation and vasopressors. Regarding primary outcome, 10 (33.3%) patients died in intervention group compared to 13 (43.3%) in placebo. Worth noting from baseline characteristics is that 86.7% in intervention arm were of severe category compared to 66.7% severe category patients in placebo group. Though number of severe cases were more in intervention arm there has been comparatively less mortality in this group. Regarding secondary outcomes, amongst 30 patients in vitamin C group, 11 (36.7%) required invasive mechanical ventilation compared to 14 (46.7%) out of 30 in placebo group but the difference was not statistically significant. Although there were a greater number of moderate cases in placebo group, invasive ventilation requirement (and NIV requirement) was more in this group, thus it could be considered that vitamin C might have a role in reducing the severity of disease. The need for vasopressor therapy was higher in intervention arm 33.3% compared to 26.7% in placebo but not significant statistically. The secondary outcomes of the study such as improvement in organ failure score (qSOFA Score), fall in level of inflammatory markers, improvement in respiratory index (pO2/fiO2 ratio), need for mechanical ventilation and need for vasopressors also shown encouraging results but not up to the statistically significant level due to moderate dosage of the drug and small sample size. In the current study, by the observations and results of the double-blind placebo controlled randomised trial, we concluded that as the primary outcome of the study, there was reduction in In-hospital mortality and need for mechanical ventilation in the vitamin C intervention group compared to placebo, although these results did not reach statistical significance due to small sample size and use of moderate dose of IV vitamin C. The secondary outcomes of the study such as improvement in organ failure score (qSOFA Score), fall in level of inflammatory markers, improvement in respiratory index (pO2/fiO2 ratio), need for mechanical ventilation and need for vasopressors also shown encouraging results but not up to the statistically significant level due to moderate dosage of the drug and small sample size. In summary, high dose of intravenous vitamin C may reduce inflammatory reaction, improve oxygen support status, and reduce mortality in COVID-19 patients, without adverse events. High dose intravenous vitamin C may be a promising therapy for patients of moderate to severe COVID-19.

Prevalence and risk factors for food allergy in children: a review of epidemiological studies

BACKGROUND: Food allergy is an actual problem in pediatric practice. In recent decades, there has been an increase in the prevalence of food allergies, as well as an increase in the number of severe cases.&#x0D; AIM: To assess the prevalence of food allergy and the role of hereditary and environmental factors in food allergy development in children according to epidemiological cohorts and cross-sectional studies.&#x0D; MATERIALS AND METHODS: A systematic review of epidemiological cohorts and cross-sectional studies published between January 1, 2000 and December 31, 2021, was conducted This review investigated the developmental factors and prevalence of food allergy.&#x0D; RESULTS: This review made it possible to generalize and systematize the accumulated worldwide scientific data on food allergy. An analysis of epidemiological studies revealed a significant prevalence of food allergy, which reflected the natural course of the disease; the highest rates were found among young children, and by school age, the prevalence of symptoms and confirmed food allergy is gradually decreasing. Based on epidemiological data, the main risk factors for food allergy are hereditary predisposition and environmental factors that modify the microbial environment.&#x0D; CONCLUSION: It is necessary to further study the genetic markers of food allergy, as well as the role of microbiotic factors in the implementation of hereditary predisposition to allergic diseases.

COVID-19 Vaccination in Health Care Workers in Italy: A Literature Review and a Report from a Comprehensive Cancer Center.

The coronavirus disease 2019 pandemic still represents a global public health emergency, despite the availability of different types of vaccines that reduced the number of severe cases, the hospitalization rate and mortality. The Italian Vaccine Distribution Plan identified healthcare workers (HCWs) as the top-priority category to receive access to a vaccine and different studies on HCWs have been implemented to clarify the duration and kinetics of antibody response. The aim of this paper is to perform a literature review across a total of 44 studies of the serologic response to COVID-19 vaccines in HCWs in Italy and to report the results obtained in a prospective longitudinal study implemented at the Fondazione IRCCS Istituto Nazionale Tumori (INT) of Milan on 1565 HCWs. At INT we found that 99.81% of the HCWs developed an antibody response one month after the second dose. About six months after the first serology evaluation, 100% of the HCWs were still positive to the antibody, although we observed a significant decrease in its levels. Overall, our literature review results highlight a robust antibody response in most of the HCWs after the second vaccination dose. These figures are also confirmed in our institutional setting seven months after the completion of the cycle of second doses of vaccination.